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Organization

DR SHAWN R LONG DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA L LONG (PARTNER)
(574) 243-8843
Entity
Organization

Contact information

Practice address
16329 STATE RD 23, SOUTH BEND, IN 46635
(574) 243-8843
(574) 243-8845
Mailing address
16329 STATE RD 23, SOUTH BEND, IN 46635
(574) 243-8843
(574) 243-8845

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009672
IN

Other

Enumeration date
11/16/2006
Last updated
08/22/2020
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