| NPI | 1215365283 |
|---|---|
| Doing Business As | LIFE LONG DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | JEREMIAH LONG Owner 203-878-4757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |