Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ETHAN MICHAEL LONG, DDS
Active Sole ProprietorDR. ETHAN MICHAEL LONG, DDS is a Dentist healthcare provider located in KODAK, Tennessee. NPI 1144679523 is currently active in the NPPES registry. Verify at CMS.
Dentist · KODAK, TN
Registration Details
- NPI Number
- 1144679523
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 7, 2016 (10.011881645652 yrs)
- Last Updated
- Jun 7, 2016
- License
-
10270 (TN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2946 WINFIELD DUNN PKWYSUITE 301KODAK, TN, 377644306Browse TN providers · Browse ZIP 37764
- Phone
- 8654657058
- Fax
- 8654653432
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in KODAK, TN
| Name | Credential | NPI |
|---|---|---|
| DR. TIFFINIE A. ALLEN-EVANS | DMD | 1912914219 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.