Provider Demographics
NPI:1275806580
Name:CAPPARELL, JOHN WILLIAM
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WILLIAM
Last Name:CAPPARELL
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JACK
Other - Middle Name:
Other - Last Name:CAPPARELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:20 N LAUREL ST
Mailing Address - Street 2:SUITE 2-C
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-5948
Mailing Address - Country:US
Mailing Address - Phone:570-454-9600
Mailing Address - Fax:
Practice Address - Street 1:20 N LAUREL ST
Practice Address - Street 2:SUITE 2-C
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-5948
Practice Address - Country:US
Practice Address - Phone:570-454-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029255L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice