| NPI | 1194976712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH S. DISTEFANO Owner/Vice President 973-748-8450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 17416) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2008-10-01 |