LONG MUGIANTO

DALLAS, TX
NPI1942529425
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: TX  27450)
Additional Taxonomies122300000X Dentist
(Licence: PA  DS038251)
Enumeration Date2010-05-24
Last Update Date2012-01-14
Business Address
Dr. LONG MUGIANTO D.M.D.
3400 LOMBARDY LN STE 100
DALLAS, TX 75220-3315
Phone number: 214-350-5333
Mailing Address
Dr. LONG MUGIANTO D.M.D.
1534 SIENNA CT
DALLAS, TX 75204-5242
Phone number: 267-997-8476
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