Provider Demographics
NPI:1548389802
Name:ELOVIC, ARAM ELAZAR (DMD)
Entity Type:Individual
Prefix:
First Name:ARAM
Middle Name:ELAZAR
Last Name:ELOVIC
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 1:665 BEACON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3202
Mailing Address - Country:US
Mailing Address - Phone:617-247-8888
Mailing Address - Fax:
Practice Address - Street 1:665 BEACON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3202
Practice Address - Country:US
Practice Address - Phone:617-247-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17210122300000X, 1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology