Timothy Parker Long II

NPI #1992111975 in Beaumont, Texas

Provider Information

NPI Number: 1992111975
Entity Type: Individual
Name: Timothy Parker Long II
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Jul 10, 2014
Last Updated: Jul 10, 2014

Practice Location

Address: 6830 PHELAN BLVD
City: Beaumont
State: Texas
ZIP Code: 77706-5970
Phone: (409) 860-9600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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