| Mastroianni Orthodontics | |
|
2220 S. State Route 157 Suite 125 Glen Carbon IL 62034-1728 | |
| (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 S. Mastroianni (DR) |
| 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 62034-1728 Ph: (618) 288-0600 | Mastroianni Orthodontics 2220 S. State Route 157 Suite 125 Glen Carbon IL 62034-1728 Ph: (618) 288-0600 |
| NPI Number | 1528187549 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 10/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528187549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 019024812 (Illinois) | Primary |
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Mastroianni Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2220 S State Route 157, Suite 125, Glen Carbon, IL 62034 Phone: 618-288-0600 Fax: 618-288-8004 | |
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