Individual
REBECCA MYNETTE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
871 OAKWOOD RD, CHARLESTON, WV 25314-2057
(304) 344-4430
(304) 345-4801
Mailing address
871 OAKWOOD RD, CHARLESTON, WV 25314-2057
(304) 344-4430
(304) 345-4801
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2852
WV
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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