SHAWN RAY LONG

SOUTH BEND, IN
NPI1194892778
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: IN  12009672)
Enumeration Date2006-11-29
Last Update Date2007-07-08
Business Address
Dr. SHAWN RAY LONG DDS
16329 STATE RD 23
SOUTH BEND, IN 46635
Phone number: 574-243-8843
Mailing Address
Dr. SHAWN RAY LONG DDS
16329 STATE RD 23
SOUTH BEND, IN 46635
Phone number: 574-243-8843