Provider Demographics
NPI:1033232517
Name:TOLMAN, MONTY D (DDS)
Entity Type:Individual
Prefix:
First Name:MONTY
Middle Name:D
Last Name:TOLMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 LILLY RD NE # A
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5031
Mailing Address - Country:US
Mailing Address - Phone:360-459-4800
Mailing Address - Fax:360-459-0052
Practice Address - Street 1:220 LILLY RD NE # A
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5031
Practice Address - Country:US
Practice Address - Phone:360-459-4800
Practice Address - Fax:360-459-0052
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA48931223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics