Organization
DR. JAMES R. LONG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES R. LONG (OWNER)
(770) 461-9642
Entity
Organization
Contact information
Practice address
1280 HIGHWAY 74 S, 110, PEACHTREE CITY, GA 30269-3077
(770) 461-9642
(770) 461-2966
Mailing address
1280 HIGHWAY 74 S, 110, PEACHTREE CITY, GA 30269-3077
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8203
GA
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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