Individual
DR. RICHARD G LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
46 OFFICE PARK DR, JACKSONVILLE, NC 28546-3217
(910) 353-3535
(910) 353-9754
Mailing address
46 OFFICE PARK DR, JACKSONVILLE, NC 28546-3217
(910) 353-3535
(910) 353-9754
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6585
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1749169
UNITED CONCORDIA
—
05
—
899018P
—
NC
01
—
9018P
BCBSNC
NC
Enumeration date
01/24/2006
Last updated
02/05/2013
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