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General NPI Number Information
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NPI Number | 1548557184
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Entity Type | Individual
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Provider Name | MARCUS BRIAN CAPALBO DMD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2011
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 81 DANIELSON PIKE
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City | NORTH SCITUATE
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State | RI
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Zip | 02857-1892
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Country | US
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Telephone | 16-475-6404
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Fax |
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Provider Business Mailing Address
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Address Line | 109 S MAIN ST B8
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2528
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Country | US
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Telephone | 401-742-0581
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN03147
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License Number State | SD
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