Long, Gary William

Long, Gary William is an individual health care provider with primary practice located at 1600 S 4Th Ave Ste 110, Morton IL 61550-2889. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Long, Gary William can be contacted via phone (309) 263-2781.

Contact Information

Primary practice address
1600 S 4Th Ave Ste 110 Morton IL 61550-2889
Phone: (309) 263-2781
Fax: (309) 263-4161
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X Illinois

Profile Details

NPI number 1417176348
LBN Legal business name Long, Gary William
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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