Provider Demographics
NPI:1568521847
Name:RAMAPO ORAL AND MAXILLOFACIAL SURGERY, PC
Entity Type:Organization
Organization Name:RAMAPO ORAL AND MAXILLOFACIAL SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAPONIGRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-357-2070
Mailing Address - Street 1:84 ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4910
Mailing Address - Country:US
Mailing Address - Phone:845-357-2070
Mailing Address - Fax:845-357-2144
Practice Address - Street 1:84 ROUTE 59
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4910
Practice Address - Country:US
Practice Address - Phone:845-357-2070
Practice Address - Fax:845-357-2144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD2W641Medicare ID - Type Unspecified