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General NPI Number Information
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NPI Number | 1710568654
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Entity Type | Organization
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Legal Business Name | DANIEL E. LONG, DDS, LLC
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 34115 STERLING HIGHWAY
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City | ANCHOR POINT
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State | AK
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Zip | 99556
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Country | US
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Telephone | 907-226-3700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 945
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City | ANCHOR POINT
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State | AK
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Zip | 99556-0945
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Country | US
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Telephone | 907-226-3700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL E LONG
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Credential | DDS
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Telephone | 907-435-9708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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