Provider Demographics
NPI:1861889271
Name:CAPITOL ORAL SURGERY ASSOCIATES
Entity type:Organization
Organization Name:CAPITOL ORAL SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:DINELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-671-5112
Mailing Address - Street 1:2405 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9429
Mailing Address - Country:US
Mailing Address - Phone:717-671-5112
Mailing Address - Fax:717-657-3314
Practice Address - Street 1:2405 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9429
Practice Address - Country:US
Practice Address - Phone:717-671-5112
Practice Address - Fax:717-657-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030841L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty