W ROGER LONG

FORT PIERCE, FL
NPI1063410462
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: FL  DN0009663)
Enumeration Date2005-07-09
Last Update Date2007-07-08
Business Address
Dr. W ROGER LONG
1511 S 25TH ST SUITE A
FORT PIERCE, FL 34947-4779
Phone number: 772-464-2943
Mailing Address
Dr. W ROGER LONG
1511 S 25TH ST SUITE A
FORT PIERCE, FL 34947-4779
Phone number: 772-464-2943