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Individual

DR. TANYA L LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
901 S 15TH ST, LOUISVILLE, KY 40210-1368
(800) 787-2812
(877) 370-6515
Mailing address
901 S 15TH ST, LOUISVILLE, KY 40210-1368
(800) 787-2812
(877) 370-6515

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8599
KY
1223G0001X
General Practice Dentistry
12011588A
IN
1223G0001X
General Practice Dentistry
Primary
8599
KY

Other

Enumeration date
06/03/2008
Last updated
10/19/2024
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