Provider Demographics
NPI:1538541636
Name:BOOKER, EMILY SUE (DMD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:SUE
Last Name:BOOKER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-1685
Mailing Address - Country:US
Mailing Address - Phone:419-933-6681
Mailing Address - Fax:
Practice Address - Street 1:500 E HOWARD ST
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-1685
Practice Address - Country:US
Practice Address - Phone:419-933-6681
Practice Address - Fax:419-935-0812
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH024532122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist