DR. Gary William Long, D.D.S.

NPI #1417176348 in Morton, Illinois

Provider Information

NPI Number: 1417176348
Entity Type: Individual
Name: DR. Gary William Long, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Apr 25, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1600 S 4TH AVE
Address 2: STE 110
City: Morton
State: Illinois
ZIP Code: 61550-2889
Phone: (309) 263-2781

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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