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General NPI Number Information
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NPI Number | 1932341955
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Entity Type | Individual
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Provider Name | JEFFREY MARSHALL CAPUTO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/06/2009
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Last Update Date | 12/10/2009
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Provider Practice Location Address
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Address Line | 26302 LA PAZ RD STE 102
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5327
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Country | US
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Telephone | 949-586-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 7 MERRIMAC
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City | IRVINE
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State | CA
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Zip | 92620-2538
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Country | US
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Telephone | 949-680-5915
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 55550
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License Number State | CA
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