Organization
JEFFREY S. MASTROIANNI, D.M.D., M.S.
Active
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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