Individual
DR. BLAISE C ECKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
15432
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015432
TUFTS HEALTH PLAN
MA
01
—
16176
HCHP
MA
Enumeration date
08/03/2006
Last updated
12/08/2009
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