Provider Demographics
NPI:1508351339
Name:CAPLE, NATHANIEL MAXWELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:MAXWELL
Last Name:CAPLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 CHESTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-1138
Mailing Address - Country:US
Mailing Address - Phone:612-875-0158
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL BEAUFORT
Practice Address - Street 2:1 PINCKNEY BLVD
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902
Practice Address - Country:US
Practice Address - Phone:843-228-5994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND140001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice