DR. Keith M Long, DDS

NPI #1649320672 in Lakeport, California

Provider Information

NPI Number: 1649320672
Entity Type: Individual
Name: DR. Keith M Long, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jan 11, 2007
Last Updated: Jun 4, 2019

Practice Location

Address: 755 11TH ST
City: Lakeport
State: California
ZIP Code: 95453-3705
Phone: (707) 263-7023

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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