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General NPI Number Information
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NPI Number | 1831307115
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Entity Type | Organization
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Legal Business Name | CAPE PERIO, INC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 09/04/2014
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Provider Practice Location Address
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Address Line | 443 ROUTE 130
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City | SANDWICH
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State | MA
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Zip | 02563
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Country | US
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Telephone | 508-888-4606
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Fax | 508-888-1359
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Provider Business Mailing Address
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Address Line | 443 ROUTE 130
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City | SANDWICH
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State | MA
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Zip | 02563
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Country | US
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Telephone | 508-888-4606
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Fax | 508-888-1349
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS J. JODOIN
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Credential | D.M.D.
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Telephone | 508-888-4606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 18818
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License Number State | MA
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