Provider Demographics
NPI:1558794610
Name:MASER, ERIC NOEL (DMD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:NOEL
Last Name:MASER
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 1:1671 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-1127
Mailing Address - Country:US
Mailing Address - Phone:860-456-3153
Mailing Address - Fax:860-456-8759
Practice Address - Street 1:1671 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-1127
Practice Address - Country:US
Practice Address - Phone:860-456-3153
Practice Address - Fax:860-456-8759
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14053122300000X
NJDI020454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist