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NPI Code Detail

MEDICARE: DR. NATHAN ALLEN TOLMAN D.M.D.

MEDICARE: DR. NATHAN ALLEN TOLMAN D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistD8281OR

General Provider Information

NPI Number : 1851542518
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN ALLEN TOLMAN D.M.D.
Provider Business Mailing Address
First Line : 21 CASCADE DR
Second Line :
City : LEBANON
State : OR
Zip : 97355-3765
Country : US
Telephone Number : 541-451-1991
Fax Number :
Provider Business Practice Location Address
First Line : 1180 S PARK ST
Second Line :
City : LEBANON
State : OR
Zip : 97355-3451
Country : US
Telephone Number : 541-451-1991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2008
Last Update Date : 12/08/2015

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