Long, Robert W

Long, Robert W is an individual health care provider with primary practice located at 2705 S Berkley Building 2 Suite B, Kokomo IN 46902-8007. He recently has 2 registered licenses in different health care specialties including Dental Providers / Pediatric Dentistry, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Pediatric Dentistry is his primary health care specialty. Long, Robert W can be contacted via phone (765) 453-2267.

Contact Information

Primary practice address
2705 S Berkley Building 2 Suite B Kokomo IN 46902-8007
Phone: (765) 453-2267
Fax: (765) 453-1150
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 12010170A Indiana
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 12010170A Indiana

Profile Details

NPI number 1659459667
LBN Legal business name Long, Robert W
Credentials DDS MSD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659459667 NPPES
Indiana Other 12010170A DENTAL LICENSE

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