Individual
DR. DEREK J EATON
Active
Individual
DR. DEREK J EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
4005
SC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9225
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4005
—
SC
Enumeration date
10/05/2006
Last updated
09/23/2011
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