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Individual

DR. MICHAEL STEVEN CAPPUCCILLI

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
13 SOMERDALE SQ, SOMERDALE, NJ 08083-1345
(856) 566-6016
(856) 566-6012
Mailing address
844 N RINGGOLD ST, PHILADELPHIA, PA 19130-1943
(215) 232-2531

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
D121111
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018341
NJ
Enumeration date
04/19/2006
Last updated
07/08/2007
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