Provider Demographics
NPI:1912301292
Name:AIJALA, EERO (DMD)
Entity Type:Individual
Prefix:
First Name:EERO
Middle Name:
Last Name:AIJALA
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 1:244 W BOYLSTON ST
Mailing Address - Street 2:STE. 8
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 W BOYLSTON ST
Practice Address - Street 2:STE. 8
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
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9459MA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist