Provider Demographics
NPI:1740352251
Name:EMMONS, TESSA HANCOCK (DMD)
Entity type:Individual
Prefix:DR
First Name:TESSA
Middle Name:HANCOCK
Last Name:EMMONS
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 1:105 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:42743-1520
Mailing Address - Country:US
Mailing Address - Phone:270-932-5609
Mailing Address - Fax:270-932-4581
Practice Address - Street 1:105 W COURT ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KY
Practice Address - Zip Code:42743-1520
Practice Address - Country:US
Practice Address - Phone:270-932-5609
Practice Address - Fax:270-932-4581
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY82261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice