# DAVID SCOTT LONG DMD LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Scott Long DMD LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750316725
- **Authorized official:** DR. DAVID SCOTT LONG DMD LLC (LLC MANAGER & PRESIDENT)
- **Authorized official phone:** (334) 712-1224

## Contact information

- **Practice address:** 1290 WESTGATE PKWY, DOTHAN, AL 36303-2153
- **Practice address phone:** (334) 712-1224
- **Practice address fax:** (334) 712-0050
- **Mailing address:** 1290 WESTGATE PKWY, DOTHAN, AL 36303-2153
- **Mailing address phone:** (334) 712-1224
- **Mailing address fax:** (334) 712-0050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4527 | AL | Yes |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 07/23/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 018149 | UNITED CONCORDIA | — |
| 01 | — | 143852 | CIGNA DENTAL HMO PLAN | FL |
| 01 | — | 20580 | BCBS ALABAMA | — |