Provider Demographics
NPI:1932364569
Name:CAPATI, ALBERT P (DMD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:P
Last Name:CAPATI
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 1:1027 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-3004
Mailing Address - Country:US
Mailing Address - Phone:217-522-4451
Mailing Address - Fax:217-522-3980
Practice Address - Street 1:1027 S 2ND ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-3004
Practice Address - Country:US
Practice Address - Phone:217-522-4451
Practice Address - Fax:217-522-3980
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.025999122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist