Individual
DR. EVAN G LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5641 POPLAR TENT RD, SUITE 201, CONCORD, NC 28027-7533
(704) 795-2300
(704) 795-2301
Mailing address
5641 POPLAR TENT RD, SUITE 201, CONCORD, NC 28027-7533
(704) 795-2300
(704) 795-2301
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6693
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
799002-T
—
NC
Enumeration date
07/28/2006
Last updated
07/08/2007
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