Organization
LONGLIFE MEDICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID C KORN D.D.S.,D.O. (MEDICAL DIRECTOR)
(480) 354-6700
Entity
Organization
Contact information
Practice address
6632 E. BASELINE RD., STE. 103, MESA, AZ 85206-4428
(480) 354-6700
(480) 354-6708
Mailing address
6632 E. BASELINE RD., STE. 103, MESA, AZ 85206-4428
(480) 354-6700
(480) 354-6708
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
3393
AZ
Other
Enumeration date
04/27/2007
Last updated
08/22/2020
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