Scott Distefano DDS Pllc

NPI #1114803483 in Longview, Texas

Provider Information

NPI Number
1114803483
Entity Type
Organization
Organization Name
Scott Distefano DDS Pllc
Primary Specialty
Dentist - General Practice
Enumeration Date
Aug 13, 2025
Last Updated
Aug 13, 2025

Practice Location

Address
3535 N FOURTH ST STE 303
State
Texas
ZIP Code
75605-0038
Phone
(903) 759-4607

Authorized Official

Name
JENNY GARCIA-ROCHA
Title
SR CREDENTIALING TEAM LEAD
Phone
(972) 869-3789

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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