Provider Demographics
NPI:1548557184
Name:CAPALBO, MARCUS BRIAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:BRIAN
Last Name:CAPALBO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S MAIN ST
Mailing Address - Street 2:B8
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2528
Mailing Address - Country:US
Mailing Address - Phone:401-742-0581
Mailing Address - Fax:
Practice Address - Street 1:81 DANIELSON PIKE
Practice Address - Street 2:
Practice Address - City:NORTH SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1892
Practice Address - Country:US
Practice Address - Phone:016-475-6404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-04
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDDEN031471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1548557184OtherDENTAL