Provider Demographics
NPI:1962546440
Name:CAPPELLI, CLIFFORD B (DMD)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:B
Last Name:CAPPELLI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 RAILROAD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:RIFLE
Mailing Address - State:CO
Mailing Address - Zip Code:81650-3334
Mailing Address - Country:US
Mailing Address - Phone:970-625-1696
Mailing Address - Fax:800-378-8718
Practice Address - Street 1:1430 RAILROAD AVE STE B
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-3334
Practice Address - Country:US
Practice Address - Phone:970-625-1696
Practice Address - Fax:800-378-8718
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO77471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice