Provider Demographics
NPI:1023798667
Name:HANDTKE, EMILY LAUREN (DDS)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:LAUREN
Last Name:HANDTKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:LAUREN
Other - Last Name:HOPTOWIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2471 COHASSET RD
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1315
Mailing Address - Country:US
Mailing Address - Phone:530-961-9288
Mailing Address - Fax:
Practice Address - Street 1:2471 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1315
Practice Address - Country:US
Practice Address - Phone:530-961-9288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108986122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist