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Contact Information

LONG FAMILY DENTISTRY INC
527 DESOTO AVENUE
CLARKSDALE, MS38614
 Phone: 662-627-2565
 Fax: 662-627-2524
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for LONG FAMILY DENTISTRY INC

NPI # 1811050313
LBN Legal business name LONG FAMILY DENTISTRY INC
Authorized official ROBERT LONG - (PRESIDENT DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 12/18/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MS License # 186980
MS Medicaid 00064885
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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