Anthony J Distefano III DDS PC

NPI #1780995894 in Worcester, Massachusetts

Provider Information

NPI Number: 1780995894
Entity Type: Organization
Organization Name: Anthony J Distefano III DDS PC
Primary Specialty: Dentist
Enumeration Date: Jun 24, 2010
Last Updated: Jun 24, 2010

Practice Location

Address: 562 LINCOLN ST
City: Worcester
State: Massachusetts
ZIP Code: 01605-1916
Phone: (508) 852-0854

Authorized Official

Name: DR. ANTHONY JAMES DISTEFANO III, D.D.S.
Title: OWNER
Phone: (508) 852-0854

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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