Individual
HAROLD MICHAEL LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
211 E LINCOLN ST, TULLAHOMA, TN 37388-3633
(931) 455-2595
(931) 455-4728
Mailing address
211 E LINCOLN ST, TULLAHOMA, TN 37388-3633
(931) 455-2595
(931) 455-4728
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2247
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12
DENTIST
TN
Enumeration date
08/11/2006
Last updated
07/08/2007
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