Provider Demographics
NPI:1538701594
Name:JOHN CAPPARELL & CONNIE MALLOZZI
Entity type:Organization
Organization Name:JOHN CAPPARELL & CONNIE MALLOZZI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CAPPARELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-454-9600
Mailing Address - Street 1:20 N LAUREL ST # 2-C
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-5948
Mailing Address - Country:US
Mailing Address - Phone:570-454-9600
Mailing Address - Fax:
Practice Address - Street 1:20 N LAUREL ST # 2-C
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-5948
Practice Address - Country:US
Practice Address - Phone:570-454-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty