W Roger Long

NPI 1063410462 - Dentist - 1223G0001X

NPI Details
NPI 1063410462
Gender Male
Enumeration Date 07/09/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
1511 S 25TH ST
SUITE A
FORT PIERCE FL, 34947-4779, US
Phone (772) 464-2943
Fax (772) 464-8801
Business Location
1511 S 25TH ST
SUITE A
FORT PIERCE FL, 34947-4779, US
Phone (772) 464-2943
Fax (772) 464-8801
Toxanomy
Taxonomy Code 1223G0001X
License State Florida
License Number DN0009663
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According to our database, Dr. W Roger Long NPI is 1063410462, taxonomy code is 1223G0001X and license number is DN0009663, license state is located at Florida. W Roger Long physically located at 1511 S 25th St, Fort Pierce FL, 34947-4779. NPI Number W Roger Long has the Individual type.

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1063410462 NPI number is provided on an as is basis without warranty of any kind. 1063410462 is maintained by the National Plan & Provider Enumeration System. The contents of W Roger Long are for informational purposes only.