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Individual
DR. JACOB DANIEL LONG
Active
Individual
DR. JACOB DANIEL LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1202497A
IN
Other
Enumeration date
06/02/2016
Last updated
09/21/2021
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