Healthcare Provider Details

I. General information

NPI: 1366675951
Provider Name (Legal Business Name): TROY SCOTT FOLLMAR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14511 S BASCOM AVE
LOS GATOS CA
95032-2003
US

IV. Provider business mailing address

14511 S BASCOM AVE
LOS GATOS CA
95032-2003
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-3146
  • Fax: 408-356-0267
Mailing address:
  • Phone: 408-356-3146
  • Fax: 408-356-0267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number58765
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: