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General NPI Number Information
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NPI Number | 1174811871
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Entity Type | Individual
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Provider Name | JEREMY F. CATMULL DMD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 15950 ELDORADO PKWY
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City | FRISCO
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State | TX
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Zip | 75035-5802
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Country | US
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Telephone | 972-542-5438
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Fax |
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Provider Business Mailing Address
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Address Line | 15950 ELDORADO PKWY
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City | FRISCO
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State | TX
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Zip | 75035-5802
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Country | US
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Telephone | 972-542-5438
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DEN.00202066
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 31797
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License Number State | TX
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