# JOSEPH DISTEFANO, DMD, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629220223
- **Authorized official:** JOSEPH M. DISTEFANO D.M.D. (OWNER/PRESIDENT)
- **Authorized official phone:** (973) 748-8450

## Contact information

- **Practice address:** 733 BLOOMFIELD AVE., BLOOMFIELD, NJ 07003
- **Practice address phone:** (973) 748-8450
- **Practice address fax:** (973) 748-8934
- **Mailing address:** 733 BLOOMFIELD AVE, BLOOMFIELD, NJ 07003
- **Mailing address phone:** (973) 748-8450
- **Mailing address fax:** (973) 748-8934

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 8974 | NJ | Yes |

## Other

- **Enumeration date:** 10/15/2008
- **Last updated:** 10/15/2008