Provider Demographics
NPI:1871631358
Name:HILO, ELMER B I (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELMER
Middle Name:B
Last Name:HILO
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16981 FOOTHILL BLVD
Mailing Address - Street 2:SUITE I
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-3581
Mailing Address - Country:US
Mailing Address - Phone:909-355-2389
Mailing Address - Fax:909-355-8870
Practice Address - Street 1:16981 FOOTHILL BLVD
Practice Address - Street 2:SUITE I
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-3581
Practice Address - Country:US
Practice Address - Phone:909-355-2389
Practice Address - Fax:909-355-8870
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39007122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist