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General NPI Number Information
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NPI Number | 1588901375
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Entity Type | Organization
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Legal Business Name | THOMAS C STREKO DMD PC
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 169 MOUNTAIN AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-3141
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Country | US
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Telephone | 908-654-0095
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Fax | 908-654-0464
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Provider Business Mailing Address
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Address Line | 169 MOUNTAIN AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-3141
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Country | US
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Telephone | 908-654-0095
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Fax | 908-654-0464
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS CHARLES STREKO
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Credential | DMD
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Telephone | 908-654-0095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DI12094
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License Number State | NJ
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