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Organization
SCOTT DISTEFANO DDS PLLC
Active
Organization
SCOTT DISTEFANO DDS PLLC
Active
Other names
DiStefano Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA-ROCHA (SR CREDENTIALING TEAM LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
3535 N FOURTH ST STE 303, LONGVIEW, TX 75605-0038
(903) 759-4607
Mailing address
3535 N FOURTH ST STE 303, LONGVIEW, TX 75605-0038
(903) 759-4607
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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