Individual
LARRY I LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7029 VISTA DR, WEST DES MOINES, IA 50266-9311
(515) 222-1244
(515) 222-4466
Mailing address
4075 HAMMONTREE CT, CLIVE, IA 50325-2529
(515) 987-4400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6990
IA
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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