Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DSO17788L | PA |
NPI | 1063847242 |
---|---|
Provider Name | Dr. Robert Capretto |
First Address | Oakmont, PA 15139-1346 |
Second Address | Oakmont, PA 15139-1346 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2013 |
Last Update Date | 06/09/2013 |