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1245673441
MICHAEL DAVID DEGOULD
ROCKFORD, IL
NPI
1245673441
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: IL 019019722)
Enumeration Date
2013-04-08
Last Update Date
2014-09-10
Business Address
Dr. MICHAEL DAVID DEGOULD DDS
2835 MCFARLAND RD SUITE C
ROCKFORD, IL 61107-6819
Phone number: 815-654-0039
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Mailing Address
Dr. MICHAEL DAVID DEGOULD DDS
2835 MCFARLAND RD SUITE C
ROCKFORD, IL 61107-6819
Phone number: 815-654-0039
Copy
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