Provider Demographics
NPI:1346569571
Name:PRESTINO, DEAN RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:RICHARD
Last Name:PRESTINO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1358 HOOPER AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2882
Mailing Address - Country:US
Mailing Address - Phone:732-914-1039
Mailing Address - Fax:
Practice Address - Street 1:1358 HOOPER AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2882
Practice Address - Country:US
Practice Address - Phone:732-914-1039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI203201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice