Provider Demographics
NPI:1427048289
Name:EMBRY, DAVID L (DMD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:EMBRY
Suffix:
Gender:M
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:PO BOX 217
Mailing Address - Street 2:8910 MAIN STREET
Mailing Address - City:CAMPBELLSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40011-0217
Mailing Address - Country:US
Mailing Address - Phone:502-532-6315
Mailing Address - Fax:502-532-6316
Practice Address - Street 1:8910 MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMPBELLSBURG
Practice Address - State:KY
Practice Address - Zip Code:40011-1427
Practice Address - Country:US
Practice Address - Phone:502-532-6315
Practice Address - Fax:502-532-6316
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY53981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice