Individual
ALLISON LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2900 GREENBRIAR DR, SPRINGFIELD, IL 62704-6418
(217) 546-0412
Mailing address
730 W WALNUT ST, CHATHAM, IL 62629-1037
(217) 622-3344
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019033721
IL
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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