Provider Demographics
NPI:1114659539
Name:CECILLE HO DDS, INC
Entity Type:Organization
Organization Name:CECILLE HO DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CECILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:909-625-6545
Mailing Address - Street 1:5153 HOLT BLVD STE A2
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-4837
Mailing Address - Country:US
Mailing Address - Phone:909-625-6545
Mailing Address - Fax:
Practice Address - Street 1:9074 BENSON AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-1615
Practice Address - Country:US
Practice Address - Phone:909-667-9810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CECILLE HO DDS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental