Provider Demographics
NPI:1588901375
Name:THOMAS C STREKO DMD PC
Entity type:Organization
Organization Name:THOMAS C STREKO DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:STREKO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-654-0095
Mailing Address - Street 1:169 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3141
Mailing Address - Country:US
Mailing Address - Phone:908-654-0095
Mailing Address - Fax:908-654-0464
Practice Address - Street 1:169 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3141
Practice Address - Country:US
Practice Address - Phone:908-654-0095
Practice Address - Fax:908-654-0464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI12094261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental