MEDICARE: DR. ANDREW CAPALDO D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS028091-L	PA

General Provider Information

NPI Number	:	1245342922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW CAPALDO D.M.D.

Provider Business Mailing Address
First Line	:	209 AMANDA LN
Second Line	:
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-1044
Country	:	US
Telephone Number	:	610-935-6879
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 W GERMANTOWN PIKE
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-1004
Country	:	US
Telephone Number	:	610-539-3979
Fax Number	:	610-539-8320

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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