Individual
DR. EDWARD KELLY FURLONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5400 W NORTHERN AVE STE 202, GLENDALE, AZ 85301-1591
(623) 500-5793
Mailing address
12226 N 56TH DR, GLENDALE, AZ 85304-1821
(406) 570-8040
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010727
AZ
Other
Enumeration date
06/18/2020
Last updated
06/18/2020
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