Provider Demographics
NPI:1053620864
Name:OLTMANN, CATRIONA CALLAN (DMD)
Entity type:Individual
Prefix:
First Name:CATRIONA
Middle Name:CALLAN
Last Name:OLTMANN
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 1:244 NAGEL DR
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160-2945
Mailing Address - Country:US
Mailing Address - Phone:870-672-4758
Mailing Address - Fax:
Practice Address - Street 1:713 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-4805
Practice Address - Country:US
Practice Address - Phone:870-673-7181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR37811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice