Provider Demographics
NPI:1821185034
Name:CECILIA CUELLAR DDS PC
Entity Type:Organization
Organization Name:CECILIA CUELLAR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUELLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-363-4361
Mailing Address - Street 1:4000 ALBEMARLE ST NW STE 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-1851
Mailing Address - Country:US
Mailing Address - Phone:202-363-4361
Mailing Address - Fax:202-363-4362
Practice Address - Street 1:4000 ALBEMARLE ST NW STE 203
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-1851
Practice Address - Country:US
Practice Address - Phone:202-363-4361
Practice Address - Fax:202-363-4362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC48031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty