| Jacob R. Long, Dds, Pllc | |
|
736 Medical Center Dr Ste 101 Wilmington NC 28401-4284 | |
| (910) 762-0255 | |
| Not Available |
| Full Name | Jacob R. Long, Dds, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 736 Medical Center Dr Ste 101, Wilmington, North Carolina |
| Authorized Official Name and Position | Jacob R. Long (DENTIST/OWNER) |
| Authorized Official Contact | 9107620355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob R. Long, Dds, Pllc 736 Medical Center Dr Ste 101 Wilmington NC 28401-4284 Ph: () - | Jacob R. Long, Dds, Pllc 736 Medical Center Dr Ste 101 Wilmington NC 28401-4284 Ph: (910) 762-0255 |
| NPI Number | 1093294076 |
|---|---|
| Provider Enumeration Date | 08/09/2018 |
| Last Update Date | 08/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093294076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 10411 (North Carolina) | Primary |
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