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Organization
DAVID SCOTT LONG DMD LLC
Active
Organization
DAVID SCOTT LONG DMD LLC
Active
Other names
Scott Long DMD LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SCOTT LONG DMD LLC (LLC MANAGER & PRESIDENT)
(334) 712-1224
Entity
Organization
Contact information
Practice address
1290 WESTGATE PKWY, DOTHAN, AL 36303-2153
(334) 712-1224
(334) 712-0050
Mailing address
1290 WESTGATE PKWY, DOTHAN, AL 36303-2153
(334) 712-1224
(334) 712-0050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4527
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018149
UNITED CONCORDIA
—
01
—
143852
CIGNA DENTAL HMO PLAN
FL
01
—
20580
BCBS ALABAMA
—
Enumeration date
07/11/2006
Last updated
07/23/2014
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