Long, Ryan R

Long, Ryan R is an individual health care provider with primary practice located at 13820 Saint Augustine Rd Ste 105 , Jacksonville FL 32258-5424. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Long, Ryan R can be contacted via phone (904) 260-7700.

Contact Information

Primary practice address
13820 Saint Augustine Rd Ste 105 Jacksonville FL 32258-5424
Phone: (904) 260-7700
Fax: (904) 260-7733
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X DN17052 Florida

Profile Details

NPI number 1912077546
LBN Legal business name Long, Ryan R
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated Apr 14th, 2010 - about 16 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 1912077546 NPPES
Florida MEDICAID 076819700

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