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1053530873
LARRY I LONG
WEST DES MOINES, IA
NPI
1053530873
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IA 6990)
Enumeration Date
2007-04-24
Last Update Date
2007-07-08
Business Address
-- LARRY I LONG DDS
7029 VISTA DR
WEST DES MOINES, IA 50266-9311
Phone number: 515-222-1244
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Mailing Address
-- LARRY I LONG DDS
4075 HAMMONTREE CT
CLIVE, IA 50325-2529
Phone number: 515-987-4400
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