Organization
CAPODICE, EFAW, OCHELTREE & ELGER PLLC
Active
Parent organization
CAPODICE, EFAW, OCHELTREE & ELGER PLLC
Other names
Drs Doran Capodice Efaw & Ocheltree LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAPODICE, EFAW, OCHELTREE & ELGER PLLC
Authorized official
MRS. KYNDRA BATA (OFFICE MANAGER)
(309) 663-2526
Entity
Organization
Contact information
Practice address
109 N REGENCY DR, BLOOMINGTON, IL 61701-3515
(309) 663-2526
(309) 663-4788
Mailing address
109 N REGENCY DR, BLOOMINGTON, IL 61701-3515
(309) 663-2526
(309) 663-4788
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
174400000X
Specialist
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Enumeration date
07/13/2005
Last updated
12/20/2023
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