Provider Demographics
NPI:1932559689
Name:ADAMSON, REGINA VERNETTA
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:VERNETTA
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:VERNETTA
Other - Last Name:ADAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BLDG 128 CHAFFEE ROAD
Mailing Address - Street 2:ATTN: DENTAC HEADQUARTERS US ARMY DENTAL ACTIVITY,
Mailing Address - City:FT BLISS
Mailing Address - State:TX
Mailing Address - Zip Code:79916
Mailing Address - Country:US
Mailing Address - Phone:915-742-6001
Mailing Address - Fax:915-742-7462
Practice Address - Street 1:BLDG 128 CHAFFEE ROAD
Practice Address - Street 2:ATTN: DENTAC HEADQUARTERS US ARMY DENTAL ACTIVITY,
Practice Address - City:FT BLISS
Practice Address - State:TX
Practice Address - Zip Code:79916
Practice Address - Country:US
Practice Address - Phone:915-742-6001
Practice Address - Fax:915-742-7462
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant