Provider Demographics
NPI:1518532043
Name:DILLMAN, EMILY YOUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:YOUNG
Last Name:DILLMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 HIGH JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-8924
Mailing Address - Country:US
Mailing Address - Phone:502-689-2479
Mailing Address - Fax:
Practice Address - Street 1:753 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-3150
Practice Address - Country:US
Practice Address - Phone:812-265-5962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013619A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist