| Mastroianni Orthodontics | |
|
2220 S State Route 157 Suite 125 Glen Carbon IL 62034-1724 | |
| (618) 288-0600 | |
| (618) 288-8004 |
| Full Name | Mastroianni Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2220 S State Route 157, Glen Carbon, Illinois |
| Authorized Official Name and Position | Jeffrey Mastroianni (CEO) |
| Authorized Official Contact | 6182880600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mastroianni Orthodontics 2220 S State Route 157 Suite 125 Glen Carbon IL 62034-1724 Ph: (618) 288-0600 | Mastroianni Orthodontics 2220 S State Route 157 Suite 125 Glen Carbon IL 62034-1724 Ph: (618) 288-0600 |
| NPI Number | 1285094862 |
|---|---|
| Provider Enumeration Date | 02/25/2016 |
| Last Update Date | 02/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285094862 | NPI | - | NPPES |
| 21002018. | Other | IL | SPECIALTY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 21002018 (Illinois) | Primary |
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