Provider Demographics
NPI:1417159567
Name:EMIL G. CAPPETTA DMD PA
Entity Type:Organization
Organization Name:EMIL G. CAPPETTA DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:G
Authorized Official - Last Name:CAPPETTA DMD PA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-277-2226
Mailing Address - Street 1:137 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2800
Mailing Address - Country:US
Mailing Address - Phone:908-277-2226
Mailing Address - Fax:
Practice Address - Street 1:137 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2800
Practice Address - Country:US
Practice Address - Phone:908-277-2226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ94551223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty