Provider Demographics
NPI:1831293463
Name:EMMONS, HAROLD KEITH (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:KEITH
Last Name:EMMONS
Suffix:
Gender:M
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 799
Mailing Address - Street 2:1130 1ST STREET N.
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-2049
Mailing Address - Country:US
Mailing Address - Phone:205-663-1280
Mailing Address - Fax:205-663-5565
Practice Address - Street 1:1130 1ST ST N
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8771
Practice Address - Country:US
Practice Address - Phone:205-663-1280
Practice Address - Fax:205-663-5565
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL39331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice