Organization
ANTHONY J DISTEFANO III DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY JAMES DISTEFANO III D.D.S. (OWNER)
(508) 852-0854
Entity
Organization
Contact information
Practice address
562 LINCOLN ST, WORCESTER, MA 01605-1916
(508) 852-0854
(508) 853-0364
Mailing address
562 LINCOLN ST, WORCESTER, MA 01605-1916
(508) 852-0854
(508) 853-0364
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12966
MA
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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