Individual
LAUREN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
705 RILEY HOSPITAL DR STE 4205, INDIANAPOLIS, IN 46202
(317) 944-9604
(317) 948-0760
Mailing address
5430 E WASHINGTON ST, SUITE 101, INDIANAPOLIS, IN 46219-6446
(317) 322-1840
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12012496A
IN
1223P0221X
Pediatric Dentistry
Primary
12012496A
IN
Other
Enumeration date
05/25/2016
Last updated
06/19/2018
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