Organization
JEFFREY S. MASTROIANNI, D.M.D., M.S.
Active
Other names
Mastroianni Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY MASTROIANNI D.M.D. (CEO)
(618) 288-0600
Entity
Organization
Contact information
Practice address
2220 S STATE ROUTE 157, SUITE 125, GLEN CARBON, IL 62034-1724
(618) 288-0600
(618) 288-8004
Mailing address
2220 S STATE ROUTE 157, SUITE 125, GLEN CARBON, IL 62034-1724
(618) 288-0600
(618) 288-8004
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21002018
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21002018.
SPECIALTY
IL
Enumeration date
02/25/2016
Last updated
02/25/2016
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