Provider Demographics
NPI:1942426978
Name:PAUL L CAPUTO, DDS PA
Entity Type:Organization
Organization Name:PAUL L CAPUTO, DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:LUCIANO
Authorized Official - Last Name:CAPUTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-789-1333
Mailing Address - Street 1:3490 E LAKE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2421
Mailing Address - Country:US
Mailing Address - Phone:727-789-1333
Mailing Address - Fax:727-772-4166
Practice Address - Street 1:3490 E LAKE RD
Practice Address - Street 2:SUITE A
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2421
Practice Address - Country:US
Practice Address - Phone:727-789-1333
Practice Address - Fax:727-772-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0011227261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental