Provider Demographics
NPI:1730480161
Name:SEA SMILES DENTAL HYGIENE
Entity Type:Organization
Organization Name:SEA SMILES DENTAL HYGIENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAPPELLO
Authorized Official - Suffix:
Authorized Official - Credentials:PHDH
Authorized Official - Phone:508-237-2187
Mailing Address - Street 1:PO BOX 914
Mailing Address - Street 2:
Mailing Address - City:WELLFLEET
Mailing Address - State:MA
Mailing Address - Zip Code:02667-0914
Mailing Address - Country:US
Mailing Address - Phone:508-237-2187
Mailing Address - Fax:
Practice Address - Street 1:5 HIDDEN ACRES LN.
Practice Address - Street 2:
Practice Address - City:WELLFLEET
Practice Address - State:MA
Practice Address - Zip Code:02667
Practice Address - Country:US
Practice Address - Phone:508-237-2187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare