Individual
EDWIN U LONG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
202 S LEXINGTON, HARRISONVILLE, MO 64701-5317
(816) 380-3522
(816) 380-6522
Mailing address
1503 E PEARL ST, HARRISONVILLE, MO 64701
(816) 380-4029
(816) 380-6522
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13126
MO
Other
Enumeration date
12/16/2005
Last updated
07/08/2007
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