Provider Demographics
NPI:1265941322
Name:VINCENT, EMILY MARIE (RDH)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:MARIE
Last Name:VINCENT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MARIE
Other - Last Name:VASSEUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:CMR 414 BOX 1452
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09173-0015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 CLARA SHUMANN STRASSE
Practice Address - Street 2:
Practice Address - City:PARSBERG
Practice Address - State:BAVARIA
Practice Address - Zip Code:92331
Practice Address - Country:DE
Practice Address - Phone:910-574-9810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10397124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist