Longwill, Thomas James

Longwill, Thomas James is an sole proprietor health care provider with primary practice located at 306 W Tilden St , Roswell NM 88203-4544. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Longwill, Thomas James can be contacted via phone (575) 623-3204.

Contact Information

Primary practice address
306 W Tilden St Roswell NM 88203-4544
Phone: (575) 623-3204
Fax: (575) 625-2071
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 1528 New Mexico

Profile Details

NPI number 1689676017
LBN Legal business name Longwill, Thomas James
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2005
Last updated Jan 25th, 2016 - about 10 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 1689676017 NPPES
New Mexico MEDICAID 0016994
New Mexico Other 851955

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