Provider Demographics
NPI:1821400862
Name:EASH, BRANDON (DMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:EASH
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 1:49 MAPLE ST STE 2C
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2883
Mailing Address - Country:US
Mailing Address - Phone:978-777-1560
Mailing Address - Fax:
Practice Address - Street 1:49 MAPLE ST STE 2C
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2883
Practice Address - Country:US
Practice Address - Phone:978-777-1560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-26
Last Update Date:2014-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18565191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice