Provider Demographics
NPI:1679652994
Name:EERO A AIJALA DMD PC
Entity Type:Organization
Organization Name:EERO A AIJALA DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EERO
Authorized Official - Middle Name:AUGUST
Authorized Official - Last Name:AIJALA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-835-4926
Mailing Address - Street 1:244 WEST BOYLSTON STREET
Mailing Address - Street 2:SUITE 9
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1790
Mailing Address - Country:US
Mailing Address - Phone:508-835-4926
Mailing Address - Fax:978-464-5065
Practice Address - Street 1:244 WEST BOYLSTON STREET
Practice Address - Street 2:SUITE 9
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1790
Practice Address - Country:US
Practice Address - Phone:508-835-4926
Practice Address - Fax:978-464-5065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA94591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty