Provider Demographics
NPI:1104171735
Name:CAPRISTO, TERESA ANGELINE (DDS)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ANGELINE
Last Name:CAPRISTO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS GERMANTOWN # 42
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96666-1730
Mailing Address - Country:US
Mailing Address - Phone:814-671-3344
Mailing Address - Fax:
Practice Address - Street 1:USS GERMANTOWN # 42
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96666-1730
Practice Address - Country:US
Practice Address - Phone:814-671-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist