Individual
DR. DANIEL J LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
113 3RD AVE NW, MANDAN, ND 58554-3129
(701) 663-2020
(701) 667-2057
Mailing address
113 3RD AVE NW, MANDAN, ND 58554-3129
(701) 663-2020
(701) 667-2057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
383
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60231
—
ND
Enumeration date
09/21/2006
Last updated
10/25/2007
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