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Contact Information

PATRICK W LONG, DDS
3775 CENTRAL AVE
SHADYSIDE, OH43947
 Phone: 740-676-2604
 Fax: 740-676-8714
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for PATRICK W LONG · (Male)

NPI Number 1932295797
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 10/05/2006
Last updated 08/08/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 17545
  • OH Medicaid 0579066
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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