Provider Demographics
NPI:1275048449
Name:ELMER E HILO II DMD, INC
Entity Type:Organization
Organization Name:ELMER E HILO II DMD, INC
Other - Org Name:ANYPLACE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:ENERIO
Authorized Official - Last Name:HILO
Authorized Official - Suffix:II
Authorized Official - Credentials:DMD
Authorized Official - Phone:909-276-4404
Mailing Address - Street 1:404 S PROSPECTORS RD STE B
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1617
Mailing Address - Country:US
Mailing Address - Phone:909-276-4404
Mailing Address - Fax:909-354-3156
Practice Address - Street 1:404 S PROSPECTORS RD STE B
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1617
Practice Address - Country:US
Practice Address - Phone:909-276-4404
Practice Address - Fax:909-354-3156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63886122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty