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Search › Tennessee › 122300000X

Ethan Long, DDS

NPI 1144679523 · on the registry since 2016 · sole proprietor

Practice

Address
2946 Winfield Dunn Pkwy
Suite 301
Kodak, TN 37764
Phone
(865) 465-7058
Fax
(865) 465-3432
Organisation at this address
Agilitas Usa, Inc
Eugene Stinson Dds
K Va T Food Stores Inc
Kodak Family Dental, Pllc
Independent Physical Therapy
Inferred from a shared address, not stated in the registry.
Clinicians at this address
17

Registry record

Primary taxonomy
122300000X
122300000X
Licence states on file
TN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-06-07

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee