Gary Robert Distefano, D.D.S.

NPI #1972602803 in Howell, Michigan

Provider Information

NPI Number: 1972602803
Entity Type: Individual
Name: Gary Robert Distefano, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Sep 21, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 112 W GRAND RIVER AVE
City: Howell
State: Michigan
ZIP Code: 48843-2268
Phone: (517) 546-8983

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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