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General NPI Number Information
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NPI Number | 1528904034
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Entity Type | Organization
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Legal Business Name | CAPDLC DENTAL PLLC
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 1224 SW GATLIN BLVD UNIT 101
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-4227
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Country | US
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Telephone | 561-560-8787
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Fax | 561-299-3800
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Provider Business Mailing Address
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Address Line | 1224 SW GATLIN BLVD UNIT 101
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-4227
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Country | US
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Telephone | 561-560-8787
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Fax | 561-299-3800
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MANUEL ARTURO CAPRILES JAQUEZ
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Credential | DDS
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Telephone | 561-560-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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