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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