Individual
DR. JOHN NORRIS LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2550 KINARD ST, NEWBERRY, SC 29108-2910
(803) 405-1111
Mailing address
2550 KINARD ST, NEWBERRY, SC 29108-2910
(803) 405-1111
(803) 405-0008
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
3388
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX3388
—
SC
Enumeration date
08/12/2006
Last updated
07/08/2007
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