Ethan M. Long, DDS
General Dentistry · Kodak, TN
UnclaimedDDSNPI 1144679523
- Primary taxonomy
- 122300000X
- Enumerated
- 2016-06-07
- Practice location
- Kodak, TN
- Last NPPES update
- 2016-06-07
State licenses
- TN · Dentist · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.