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Individual

DR. THOMAS V DISTEFANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
25 MOUNTAINVIEW BLVD STE 205, BASKING RIDGE, NJ 07920-3453
(908) 604-0200
(908) 686-6301
Mailing address
2333 MORRIS AVE, SUITE D105, UNION, NJ 07083
(908) 686-5277
(908) 686-6301

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI01562000
NJ

Other

Enumeration date
05/29/2008
Last updated
08/25/2020
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