Provider Demographics
NPI:1881029130
Name:EMERICK, COLLIN (DDS)
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:
Last Name:EMERICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4693 MORSE RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1375
Mailing Address - Country:US
Mailing Address - Phone:614-471-7800
Mailing Address - Fax:
Practice Address - Street 1:4693 MORSE RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1375
Practice Address - Country:US
Practice Address - Phone:614-471-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0240791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice