Provider Demographics
NPI:1194840058
Name:WEINSTOCK, ERIC L (DMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:L
Last Name:WEINSTOCK
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 1:95 WASHINGTON ST
Mailing Address - Street 2:SUITE 482
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021
Mailing Address - Country:US
Mailing Address - Phone:781-575-9633
Mailing Address - Fax:781-575-0086
Practice Address - Street 1:95 WASHINGTON ST
Practice Address - Street 2:SUITE 482
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021
Practice Address - Country:US
Practice Address - Phone:781-575-9633
Practice Address - Fax:781-575-0086
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA200671223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics