Provider Demographics
NPI:1528471778
Name:MARX, EMILY KAY (DDS)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KAY
Last Name:MARX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5708 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-3962
Mailing Address - Country:US
Mailing Address - Phone:816-452-2000
Mailing Address - Fax:816-452-4069
Practice Address - Street 1:5708 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-3962
Practice Address - Country:US
Practice Address - Phone:816-452-2000
Practice Address - Fax:816-452-4069
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140168191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice