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Organization

283 HURLEY AVE DENTAL, PLLC

Active
Other names
Dr. Gene DeStefano, DDS
Organization subpart
No

Provider details

NPI number
Authorized official
EMILY MAISCH (DIRECTOR OF OPERATIONS)
(845) 430-9394
Entity
Organization

Contact information

Practice address
283 HURLEY AVE, KINGSTON, NY 12401-2421
(845) 430-9394
Mailing address
283 HURLEY AVE, KINGSTON, NY 12401-2421
(845) 430-9394

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1780690958
NPI
NY
Enumeration date
10/13/2022
Last updated
10/13/2022
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