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General NPI Number Information
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NPI Number | 1306216114
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Entity Type | Individual
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Provider Name | ERIC WILLIAM EL MASRI DMD
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Gender | Male
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 10/06/2015
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Provider Practice Location Address
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Address Line | 927 PUTNEY RD
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City | BRATTLEBORO
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State | VT
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Zip | 05301-9048
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Country | US
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Telephone | 802-342-4633
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Fax |
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Provider Business Mailing Address
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Address Line | 323 MAPLE AVE APT 19
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City | KEENE
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State | NH
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Zip | 03431-1608
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Country | US
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Telephone | 802-342-4633
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0160114969
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License Number State | VT
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