Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DS015860L | PA |
NPI | 1396714275 |
---|---|
Provider Name | Dr. Anthony M. Captline |
First Address | Coraopolis, PA 15108-2653 |
Second Address | Coraopolis, PA 15108-2653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 08/07/2007 |