Organization
ROBERT M. LONG, DDS. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT MICHAEL LONG D.D.S. (PRESIDENT)
(808) 245-3722
Entity
Organization
Contact information
Practice address
4359 KUKUI GROVE STREET, SUITE 104, LIHUE, HI 96766
(808) 245-3722
(808) 245-1641
Mailing address
4359 KUKUI GROVE STREET, SUITE 104, LIHUE, HI 96766
(808) 245-3722
(808) 245-1641
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
939
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067077-01
—
HI
Enumeration date
07/19/2018
Last updated
07/19/2018
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