Individual
BLONG ROGER LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5100 OBYRNES FERRY RD, JAMESTOWN, CA 95327-9102
(209) 984-5291
Mailing address
5100 O'BYRNES FERRY ROAD, JAMESTOWN, CA 95327
(209) 984-5291
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
51106
CA
Other
Enumeration date
01/30/2006
Last updated
09/16/2013
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