Provider Demographics
NPI:1609843184
Name:EASLON, REGINA DIANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:DIANE
Last Name:EASLON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 648
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75461-0648
Mailing Address - Country:US
Mailing Address - Phone:903-785-2580
Mailing Address - Fax:903-784-7004
Practice Address - Street 1:305 STONE AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-1910
Practice Address - Country:US
Practice Address - Phone:903-785-2580
Practice Address - Fax:903-784-7004
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX157131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice