Organization
DAVID SCOTT LONG DMD LLC
Active
Other names
Scott Long DMD LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SCOTT LONG DMD LLC (LLC MANAGER & PRESIDENT)
(334) 712-1224
Entity
Organization
Contact information
Practice address
1290 WESTGATE PKWY, DOTHAN, AL 36303-2153
(334) 712-1224
(334) 712-0050
Mailing address
1290 WESTGATE PKWY, DOTHAN, AL 36303-2153
(334) 712-1224
(334) 712-0050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4527
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018149
UNITED CONCORDIA
—
01
—
143852
CIGNA DENTAL HMO PLAN
FL
01
—
20580
BCBS ALABAMA
—
Enumeration date
07/11/2006
Last updated
07/23/2014
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