Provider Demographics
NPI:1295082345
Name:TOLMAN, BRIAN ANDREW (DMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANDREW
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 1:822 E UNION HILLS DR
Mailing Address - Street 2:SUITE D-6
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-8403
Mailing Address - Country:US
Mailing Address - Phone:623-582-6789
Mailing Address - Fax:
Practice Address - Street 1:822 E UNION HILLS DR
Practice Address - Street 2:SUITE D-6
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-8403
Practice Address - Country:US
Practice Address - Phone:623-582-6789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ84401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice