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Individual
DR. RICHARD JONATHAN LONG
Active
Individual
DR. RICHARD JONATHAN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401416395
VA
1223G0001X
General Practice Dentistry
Primary
3087
VI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2018
Last updated
04/06/2021
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