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General NPI Number Information
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NPI Number | 1912890898
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Entity Type | Individual
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Provider Name | ERIN EILEEN EMMERT
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Gender | Female
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1726 LEONARD ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-5636
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Country | US
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Telephone | 616-459-0478
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Fax |
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Provider Business Mailing Address
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Address Line | 9610 BURNING TREE DR
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City | GRAND BLANC
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State | MI
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Zip | 48439-9568
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Country | US
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Telephone | 810-869-2298
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901602622
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License Number State | MI
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