Organization
LIFE LONG DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMIAH LONG DMD (DENTIST)
(860) 388-0242
Entity
Organization
Contact information
Practice address
123 ELM ST, SUITE 900, OLD SAYBROOK, CT 06475-4108
(860) 388-0242
(860) 388-6495
Mailing address
123 ELM ST, SUITE 900, OLD SAYBROOK, CT 06475-4108
(860) 388-0242
(860) 388-6495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07944
CT
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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