Organization
ADVANCED DENTAL AESTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH S. DISTEFANO DMD (OWNER/VICE PRESIDENT)
(973) 748-8450
Entity
Organization
Contact information
Practice address
400 MAIN ST., BEDMINSTER, NJ 07921
(908) 901-9001
Mailing address
733 BLOOMFIELD AVE., BLOOMFIELD, NJ 07003
(973) 748-8450
(973) 748-8934
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17416
NJ
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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