Individual
DR. MICHAEL DAVID DEGOULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2835 MCFARLAND RD, SUITE C, ROCKFORD, IL 61107-6819
(815) 654-0039
(815) 654-0650
Mailing address
2835 MCFARLAND RD, SUITE C, ROCKFORD, IL 61107-6819
(815) 654-0039
(815) 654-0650
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019019722
IL
Other
Enumeration date
04/08/2013
Last updated
09/10/2014
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