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General NPI Number Information
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NPI Number | 1497127880
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Entity Type | Individual
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Provider Name | BRENDA SCHOBERT CAPETILLO DDS
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Gender | Female
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Dates
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Enumeration Date | 10/24/2015
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Last Update Date | 10/24/2015
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Provider Practice Location Address
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Address Line | 2801 N UNIVERSITY DR STE 202
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5053
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Country | US
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Telephone | 954-227-8133
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Fax |
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Provider Business Mailing Address
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Address Line | 4080 FERN FOREST RD
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City | HOLLYWOOD
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State | FL
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Zip | 33026-1173
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Country | US
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Telephone | 954-815-8265
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN21577
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License Number State | FL
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