Provider Demographics
NPI:1174811871
Name:CATMULL, JEREMY F (DMD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:F
Last Name:CATMULL
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 1:15950 ELDORADO PKWY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5802
Mailing Address - Country:US
Mailing Address - Phone:972-542-5438
Mailing Address - Fax:
Practice Address - Street 1:15950 ELDORADO PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5802
Practice Address - Country:US
Practice Address - Phone:972-542-5438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002020661223P0221X
TX317971223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry