Individual
CATHY EVANS LONGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
22A GLEN ED PROFESSIONAL PARK, GLEN CARBON, IL 62034
(618) 656-7615
Mailing address
22A GLEN ED PROFESSIONAL PARK, GLEN CARBON, IL 62034
(618) 656-7615
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019021729
IL
1223E0200X
Endodontics
Primary
021001620
IL
Other
Enumeration date
12/13/2006
Last updated
06/21/2016
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