Provider Demographics
NPI:1851542518
Name:TOLMAN, NATHAN ALLEN (DMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ALLEN
Last Name:TOLMAN
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 1:21 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-3765
Mailing Address - Country:US
Mailing Address - Phone:541-451-1991
Mailing Address - Fax:
Practice Address - Street 1:1180 S PARK ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-3451
Practice Address - Country:US
Practice Address - Phone:541-451-1991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8281122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist