Provider Demographics
NPI:1184837296
Name:CAPITAL ENDODONTICS LLC
Entity Type:Organization
Organization Name:CAPITAL ENDODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:CARYL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-442-3300
Mailing Address - Street 1:2418 CROSSROADS DR
Mailing Address - Street 2:2900
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-2425
Mailing Address - Country:US
Mailing Address - Phone:608-442-3300
Mailing Address - Fax:608-442-3303
Practice Address - Street 1:2418 CROSSROADS DR
Practice Address - Street 2:2900
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-2425
Practice Address - Country:US
Practice Address - Phone:608-442-3300
Practice Address - Fax:608-442-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty