Provider Demographics
NPI:1346326436
Name:MELO, HILARIO JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:HILARIO
Middle Name:JOSEPH
Last Name:MELO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:LARRY
Other - Middle Name:JOSEPH
Other - Last Name:MELO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:314 N PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:HERKIMER
Mailing Address - State:NY
Mailing Address - Zip Code:13350-1911
Mailing Address - Country:US
Mailing Address - Phone:315-866-2970
Mailing Address - Fax:
Practice Address - Street 1:314 N PROSPECT ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-1911
Practice Address - Country:US
Practice Address - Phone:315-866-2970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0446501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice