Individual
DAVID LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
40 W CALDWELL ST STE 101, MOUNT JULIET, TN 37122-3177
(615) 754-5840
(615) 773-1029
Mailing address
40 W CALDWELL ST STE 101, MOUNT JULIET, TN 37122-3177
(615) 754-5840
(615) 773-1029
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11555
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2020
Last updated
09/13/2021
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