Provider Demographics
NPI:1235453184
Name:OSCAR A. CELIS DDS & JOSE A. CELIS, DDS, INC
Entity Type:Organization
Organization Name:OSCAR A. CELIS DDS & JOSE A. CELIS, DDS, INC
Other - Org Name:DBA:MONTAGUE HILLS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDNET/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CELIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-262-9999
Mailing Address - Street 1:991 MONTAGUE EXPRESSWAY
Mailing Address - Street 2:SUITE #211
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035
Mailing Address - Country:US
Mailing Address - Phone:408-262-9999
Mailing Address - Fax:408-262-9998
Practice Address - Street 1:991 MONTAGUE EXPRESSWAY
Practice Address - Street 2:SUITE #211
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035
Practice Address - Country:US
Practice Address - Phone:408-262-9999
Practice Address - Fax:408-262-9998
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSCAR A. CELIS DDS & JOSE A. CELIS, DDS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA519031223G0001X
CA434301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty