Provider Demographics
NPI:1710059886
Name:CATRON, TAMMRA S (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAMMRA
Middle Name:S
Last Name:CATRON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 HOPEWELL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-5392
Mailing Address - Country:US
Mailing Address - Phone:502-266-5661
Mailing Address - Fax:502-267-5766
Practice Address - Street 1:3701 HOPEWELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-5392
Practice Address - Country:US
Practice Address - Phone:502-266-5661
Practice Address - Fax:502-267-5766
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY61801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice