Organization
LONG ,LAXER & SAVAGE DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINWOOD MARVIN LONG JR. DDS, MS, D. ORTHO (DENTIST / ORTHODONTIST)
(704) 759-0000
Entity
Organization
Contact information
Practice address
7820 BALLANTYNE COMMONS PKWY, SUITE 200, CHARLOTTE, NC 28277-2841
(704) 759-0000
(704) 759-9937
Mailing address
7820 BALLANTYNE COMMONS PKWY, SUITE 200, CHARLOTTE, NC 28277-2841
(704) 759-0000
(704) 759-9937
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0138
NC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0138
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143881557
DR. LAXER'S ADA#
—
01
—
148760706
DR. LONG'S ADA#
—
05
—
899016K
—
NC
05
—
89902XA
—
NC
05
—
8995372
—
NC
01
—
9016K
DR. LAXER'S BCBS#
NC
01
—
902XA
DR. SAVAGE'S BCBS#
NC
01
—
95372
DR. LONG'S BCBS#
NC
Enumeration date
07/18/2005
Last updated
03/07/2023
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