Individual
MICHAEL LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
310 MAIN STREET, EAST HAVEN, CT 06512
(203) 469-8057
(203) 469-8058
Mailing address
310 MAIN STREET, EAST HAVEN, CT 06512
(203) 469-8057
(203) 469-8058
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8159
CT
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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