Individual
DR. JERROD D. LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
#2 NACO ROAD, BISBEE, AZ 85603-2898
(520) 432-5370
(520) 432-6658
Mailing address
#2 NACO ROAD, BOX 1898, BISBEE, AZ 85603-2898
(520) 432-5371
(520) 432-6658
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5037
AZ
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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