Organization
ETHAN LONG DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET LATHAM (OFFICE MANAGER)
(865) 984-7757
Entity
Organization
Contact information
Practice address
1105 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5130
(865) 984-7757
(865) 724-2272
Mailing address
1105 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5130
(865) 984-7757
(865) 724-2272
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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