Individual provider · Type 1 NPI

Nicholas John Distefano, DMD

Student in an Organized Health Care Education/Training Program · Hartford, CT

NPI number 1255780672 Active

Practice location

80 Seymour St
Hartford, CT 06102-8000

Call (860) 545-5000 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1255780672

Nicholas John Distefano, DMD's National Provider Identifier is 1255780672, issued on Jun 7, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Hartford, CT. The record was last updated on Jun 7, 2016.