LARRY I LONG

WEST DES MOINES, IA
NPI1053530873
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IA  6990)
Enumeration Date2007-04-24
Last Update Date2007-07-08
Business Address
-- LARRY I LONG DDS
7029 VISTA DR
WEST DES MOINES, IA 50266-9311
Phone number: 515-222-1244
Mailing Address
-- LARRY I LONG DDS
4075 HAMMONTREE CT
CLIVE, IA 50325-2529
Phone number: 515-987-4400