Provider Demographics
NPI:1245322403
Name:SALES, REGAN BRADFORD (DDS)
Entity type:Individual
Prefix:DR
First Name:REGAN
Middle Name:BRADFORD
Last Name:SALES
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 1:1405 W FRANKFORD RD STE 112
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-4900
Mailing Address - Country:US
Mailing Address - Phone:972-245-4886
Mailing Address - Fax:972-245-4977
Practice Address - Street 1:1405 W FRANKFORD RD STE 112
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-4900
Practice Address - Country:US
Practice Address - Phone:972-245-4886
Practice Address - Fax:972-245-4977
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20745122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist