Healthcare Provider Details

I. General information

NPI: 1861188088
Provider Name (Legal Business Name): EMERY ANNE BUCKHOUSE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3928 MONTCLAIR RD STE 120
MOUNTAIN BRK AL
35213-2415
US

IV. Provider business mailing address

3928 MONTCLAIR RD STE 120
MOUNTAIN BRK AL
35213-2415
US

V. Phone/Fax

Practice location:
  • Phone: 205-957-0106
  • Fax:
Mailing address:
  • Phone: 205-957-0106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number007599
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: