Dr. John Conrad Mastrud, D.D.S.
Dentist in Lemont, IL. Individual provider (NPI-1).
NPI number1366577652
StatusActive
Last updated in NPPESOct 21, 2014
Details
- NPI
- 1366577652
- Entity type
- Individual (NPI-1)
- Name
- Dr. John Conrad Mastrud
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 23, 2007
- Last updated
- Oct 21, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 019-023242 | IL | Yes |
Practice location
15947 W 127th StSuite H
Lemont, IL 60439-7421
Phone 630-257-2133 · Fax 630-257-2146
Mailing address
15947 W. 127th StreetSuite H
Lemont, IL 60439
Phone 630-257-2133 · Fax 630-257-2146
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