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Organization
EMELINE T. DAVIS
Active
Organization
EMELINE T. DAVIS
Active
Other names
Advanced Dental LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMELINE T. DAVIS D.D.S. (DENTIST)
(812) 232-4664
Entity
Organization
Contact information
Practice address
2955 PROFESSIONAL LN, TERRE HAUTE, IN 47802-3300
(812) 232-4664
(812) 234-5427
Mailing address
2955 PROFESSIONAL LN, TERRE HAUTE, IN 47802-3300
(812) 232-4664
(812) 234-5427
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008723
IN
122300000X
Dentist
12009834
IN
122300000X
Dentist
12010103
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100251550A
—
IN
Enumeration date
11/09/2005
Last updated
04/26/2010
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