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Individual

ANDREA EMMERICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
2126 N HIGHWAY 81, ANDERSON, SC 29621-1532
(920) 676-4971
Mailing address
1795 CAMARILLO CT., DE PERE, WI 54115
(920) 676-4971

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001339 - 15
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/09/2016
Last updated
07/14/2016
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