Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 22D102564900 | NJ |
NPI | 1043572969 |
---|---|
Provider Name | Dr. Emil John Armand Cappetta |
First Address | Montclair, NJ 07042-2137 |
Second Address | Montclair, NJ 07042-2137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2012 |
Last Update Date | 26/07/2016 |