Individual
DR. TIFFANI ANN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
181 W MAIN ST, FARMINGTON, AR 72730-2945
(661) 345-4578
Mailing address
181 W MAIN ST, FARMINGTON, AR 72730-2945
(661) 345-4578
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3650
AR
1223G0001X
General Practice Dentistry
47705
CA
Other
Enumeration date
04/02/2008
Last updated
04/28/2008
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