Provider Demographics
NPI:1346439486
Name:CAPPELLI DENTAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:CAPPELLI DENTAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:O
Authorized Official - Last Name:CAPPELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-666-8989
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI008494001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty