James Enochs Long, DDS

Individual provider Active NPI General Practice Dentistry · Starkville, MS

NPI 1619084191 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1619084191
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
80356 (MS)
Practice address
300 Greensboro St
Starkville, MS 39759
Phone
(662) 323-2876
Fax
(662) 323-4876
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
80356MSMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 80356 MS Yes

Addresses

Primary practice location

300 Greensboro St
Starkville, MS 39759

Mailing address

PO Box 907
Starkville, MS 39760-0907
Phone (662) 323-2876

Other providers in Starkville, MS

All providers in Starkville, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.