Provider Demographics
NPI:1629157334
Name:SPRADLIN, EMORY P (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMORY
Middle Name:P
Last Name:SPRADLIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:PRINCETON
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-0071
Mailing Address - Country:US
Mailing Address - Phone:270-365-7244
Mailing Address - Fax:270-365-7244
Practice Address - Street 1:406 W WASHINGTON ST
Practice Address - Street 2:PRINCETON
Practice Address - City:PRINCETON
Practice Address - State:KY
Practice Address - Zip Code:42445-1938
Practice Address - Country:US
Practice Address - Phone:270-365-7244
Practice Address - Fax:270-365-7244
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY82091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice