Individual
DAVID JORDAN EISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(732) 547-0591
Mailing address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(732) 547-0591
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1858476
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2019
Last updated
04/06/2020
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