Individual
DR. MICHAEL MASONCUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1309 W MAIN ST, ST CHARLES, IL 60174-1623
(630) 584-6340
Mailing address
36W447 FERSON CREEK RD, ST CHARLES, IL 60174-1120
(630) 584-4617
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-15590
IL
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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