Individual
JEFFREY SCOTT MASTROIANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2220 S. STATE ROUTE 157, SUITE 125, GLEN CARBON, IL 62034-1728
(618) 288-0600
(618) 288-8004
Mailing address
2220 S. STATE ROUTE 157, SUITE 125, GLEN CARBON, IL 62034-1728
(618) 288-0600
(618) 288-8004
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002018
IL
Other
Enumeration date
09/22/2006
Last updated
10/24/2014
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