Provider Demographics
NPI:1649724428
Name:REGAN B. SALES
Entity type:Organization
Organization Name:REGAN B. SALES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REGAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SALES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-245-4886
Mailing Address - Street 1:1735 KELLER SPRINGS RD STE 212
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-3014
Mailing Address - Country:US
Mailing Address - Phone:972-245-4886
Mailing Address - Fax:972-245-4886
Practice Address - Street 1:1735 KELLER SPRINGS RD STE 212
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-3014
Practice Address - Country:US
Practice Address - Phone:972-245-4886
Practice Address - Fax:972-245-4886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20745122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty