Individual
DR. IAN BRADLEY EMERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9215 STATE ROAD 64, GEORGETOWN, IN 47122-8833
(812) 951-3776
Mailing address
PO BOX 105, GEORGETOWN, IN 47122-0105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013183A
IN
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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