Provider Demographics
NPI:1922176445
Name:JAMES E. SCAPILLATO D.D.S., P.C.
Entity Type:Organization
Organization Name:JAMES E. SCAPILLATO D.D.S., P.C.
Other - Org Name:FAMILY DENTAL CARE OF OAK PARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCAPILLATO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-848-3727
Mailing Address - Street 1:6943 W. NORTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1024
Mailing Address - Country:US
Mailing Address - Phone:708-848-3727
Mailing Address - Fax:708-848-6591
Practice Address - Street 1:6943 W. NORTH AVENUE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1024
Practice Address - Country:US
Practice Address - Phone:708-848-3727
Practice Address - Fax:708-848-6591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty