Individual
DR. NICHOLAS JOHN DISTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06102-8000
(860) 545-5000
Mailing address
80 SEYMOUR ST, HARTFORD, CT 06102-8000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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