Long, Larry Keith

Long, Larry Keith is an individual health care provider with primary practice located at 2624 Jenks Ave Ste 1 , Panama City FL 32405. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Long, Larry Keith can be contacted via phone (210) 667-5171.

Contact Information

Primary practice address
2624 Jenks Ave Ste 1 Panama City FL 32405
Phone: (210) 667-5171
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 6538 North Carolina
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DN23806 Florida
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X DN23806 Florida
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 23649 Texas

Profile Details

NPI number 1275527137
LBN Legal business name Long, Larry Keith
Credentials DDS,MD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated Nov 30th, 2020 - about 5 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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