Individual
JACLYN MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2214 N UNIVERSITY ST, PEORIA, IL 61604-3221
(309) 680-7600
Mailing address
6747 W HIGHLAND DR, PALOS HEIGHTS, IL 60463-2218
(708) 712-6727
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031141
IL
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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