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General NPI Number Information
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NPI Number | 1265613392
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Entity Type | Organization
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Legal Business Name | WILLIAM CAPOBIANCO, D.D.S., INC
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 665 CAMINO DE LOS MARES SUITE 303
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-2835
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Country | US
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Telephone | 949-443-2404
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Fax | 949-443-2324
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Provider Business Mailing Address
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Address Line | 665 CAMINO DE LOS MARES SUITE 303
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City | SAN CLEMENTE
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State | CA
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Zip | 92673
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Country | US
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Telephone | 949-443-2404
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Fax | 949-443-2324
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Authorized Official
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Title or Position | CEO
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Name | DR. WILLIAM CAPOBIANCO
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Credential | DDS
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Telephone | 949-443-2404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39241
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License Number State | CA
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