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1194892778
SHAWN RAY LONG
SOUTH BEND, IN
NPI
1194892778
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IN 12009672)
Enumeration Date
2006-11-29
Last Update Date
2007-07-08
Business Address
Dr. SHAWN RAY LONG DDS
16329 STATE RD 23
SOUTH BEND, IN 46635
Phone number: 574-243-8843
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Mailing Address
Dr. SHAWN RAY LONG DDS
16329 STATE RD 23
SOUTH BEND, IN 46635
Phone number: 574-243-8843
Copy
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