Individual
DR. DAVID GLENN LONG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1697 142ND AVE, DORR, MI 49323-9426
(616) 681-9943
Mailing address
1697 142ND AVE, DORR, MI 49323-9426
(616) 681-9943
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015170
MI
Other
Enumeration date
06/02/2006
Last updated
07/08/2007
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