Provider Demographics
NPI:1861188088
Name:BUCKHOUSE, EMERY ANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:EMERY
Middle Name:ANNE
Last Name:BUCKHOUSE
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 1:4615 FOREST DR APT 401
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-3178
Mailing Address - Country:US
Mailing Address - Phone:843-992-2554
Mailing Address - Fax:
Practice Address - Street 1:948 OLD CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-8123
Practice Address - Country:US
Practice Address - Phone:803-356-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC102571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice