Provider Demographics
NPI:1245481456
Name:ELIAS, HIAM (DMD, PC)
Entity type:Individual
Prefix:DR
First Name:HIAM
Middle Name:
Last Name:ELIAS
Suffix:
Gender:F
Credentials:DMD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ESSEX CTR. DR.
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960
Mailing Address - Country:US
Mailing Address - Phone:978-532-0088
Mailing Address - Fax:978-532-0089
Practice Address - Street 1:6 ESSEX CTR. DR.
Practice Address - Street 2:SUITE 302
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960
Practice Address - Country:US
Practice Address - Phone:514-501-7801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0098951223G0001X
MADN18553311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice