Provider Demographics
NPI:1881833143
Name:EMRICH, JOHN NORMAN (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:NORMAN
Last Name:EMRICH
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 1:1018 MURRIETA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4163
Mailing Address - Country:US
Mailing Address - Phone:925-443-2060
Mailing Address - Fax:925-443-3032
Practice Address - Street 1:1018 MURRIETA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4163
Practice Address - Country:US
Practice Address - Phone:925-443-2060
Practice Address - Fax:925-443-3032
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA179081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics