Provider Demographics
NPI:1942237508
Name:CAPUA, JOHN K (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:K
Last Name:CAPUA
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 1:576 PACIFIC DR
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-1406
Mailing Address - Country:US
Mailing Address - Phone:801-756-1009
Mailing Address - Fax:801-763-9380
Practice Address - Street 1:576 PACIFIC DR
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-1406
Practice Address - Country:US
Practice Address - Phone:801-756-1009
Practice Address - Fax:801-763-9380
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1411801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice