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Organization

JOSEPH DISTEFANO, DMD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH M. DISTEFANO D.M.D. (OWNER/PRESIDENT)
(973) 748-8450
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8974
NJ

Other

Enumeration date
10/15/2008
Last updated
10/15/2008
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