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Individual

DR. RICHARD JONATHAN LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
9151 ESTATE THOMAS STE 203, ST THOMAS, VI 00802-2716
(804) 726-0962
Mailing address
8316 OLD CAVALRY DR, MECHANICSVILLE, VA 23111-4534
(804) 726-0962

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
0401416395
VA
1223G0001X
General Practice Dentistry
Primary
3087
VI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/09/2018
Last updated
04/06/2021
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