Individual
DR. WALTER R. LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
10 FARMFIELD AVE STE E, CHARLESTON, SC 29407-7756
(843) 766-0112
Mailing address
846 SAINT ANDREWS BLVD STE C, CHARLESTON, SC 29407-7148
(843) 225-9002
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
3707
SC
Other
Enumeration date
04/26/2007
Last updated
05/19/2025
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