DR. Jack Capodice JR., MD, DMD
NPI #1053397612 in Bloomington, Illinois
Provider Information
- NPI Number
- 1053397612
- Entity Type
- Individual
- Name
- DR. Jack Capodice JR., MD, DMD
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - Oral and Maxillofacial Pathology
- Credential
- MD, DMD
- Enumeration Date
- Dec 15, 2005
- Last Updated
- Mar 7, 2023
Practice Location
- Address
- 109 N REGENCY DR
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61701-3515
- Phone
- (309) 663-2526
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Pathology — Oral and Maxillofacial Pathology |
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