Provider Demographics
NPI:1053304493
Name:CAPPELLI, ALFRED O (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:O
Last Name:CAPPELLI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:M
Other - Last Name:CAPPELLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:156 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-2034
Mailing Address - Country:US
Mailing Address - Phone:201-666-8989
Mailing Address - Fax:201-666-8999
Practice Address - Street 1:156 BROADWAY
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-2034
Practice Address - Country:US
Practice Address - Phone:201-666-8989
Practice Address - Fax:201-666-8999
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI008494001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice