Individual
DR. EMILY ANNE LATTA GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
4001 BALMORAL DR SW, HUNTSVILLE, AL 35801-6403
(256) 539-7447
Mailing address
4001 BALMORAL DR SW, HUNTSVILLE, AL 35801-6403
(256) 539-7447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
6215
AL
1223P0221X
Pediatric Dentistry
Primary
6215
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2015
Last updated
06/18/2019
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