NPI 1811050313

Long Family Dentistry INC

Organisation Dentist Clarksdale, MS

Practice location

Address: 527 Desoto Avenue, Clarksdale, MS 38614
Phone: (662) 627-2565
Fax: (662) 627-2524
Mailing address: Post Office Box 291, Clarksdale, MS 38614

Authorised official

Name: Robert E Long
Title: President Dentist
Phone: (662) 627-2565

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 186980 (MS)

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Registry record

NPI: 1811050313
Entity type: Organization
NPI issued: 18 Dec 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.