# ROBERT D. LONG DDS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780043018
- **Authorized official:** DR. ROBERT D LONG DDS (PRESIDENT/DENTIST)
- **Authorized official phone:** (913) 491-3353

## Contact information

- **Practice address:** 11111 NALL AVE STE 109, LEAWOOD, KS 66211-1625
- **Practice address phone:** (913) 491-3353
- **Practice address fax:** (913) 491-1042
- **Mailing address:** 11111 NALL AVE STE 109, LEAWOOD, KS 66211-1625
- **Mailing address phone:** (913) 491-3353
- **Mailing address fax:** (913) 491-1042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | KS 6019 | KS | Yes |

## Other

- **Enumeration date:** 02/15/2016
- **Last updated:** 02/15/2016