Provider Demographics
NPI:1740730043
Name:EMILY L DENNISON DDS, INC
Entity type:Organization
Organization Name:EMILY L DENNISON DDS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:LINNEA
Authorized Official - Last Name:DENNISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-578-8232
Mailing Address - Street 1:1412 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1005
Mailing Address - Country:US
Mailing Address - Phone:614-578-8232
Mailing Address - Fax:
Practice Address - Street 1:1412 N COURT ST
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1005
Practice Address - Country:US
Practice Address - Phone:614-578-8232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30024628261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental