Provider Demographics
NPI:1831307115
Name:CAPE PERIO, INC
Entity Type:Organization
Organization Name:CAPE PERIO, INC
Other - Org Name:1261 FURNACE BROOK PARKWAY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:JODOIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-888-4606
Mailing Address - Street 1:443 ROUTE 130
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563
Mailing Address - Country:US
Mailing Address - Phone:508-888-4606
Mailing Address - Fax:508-888-1349
Practice Address - Street 1:443 ROUTE 130
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563
Practice Address - Country:US
Practice Address - Phone:508-888-4606
Practice Address - Fax:508-888-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA188181223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty