Provider Demographics
NPI:1851605422
Name:REGNIER, STEPHEN RAYMOND (DMD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:RAYMOND
Last Name:REGNIER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6132 CAROLINA BEACH RD STE 6
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2759
Mailing Address - Country:US
Mailing Address - Phone:910-392-9101
Mailing Address - Fax:
Practice Address - Street 1:6132 CAROLINA BEACH RD STE 6
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2759
Practice Address - Country:US
Practice Address - Phone:910-392-9101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9970122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist