Long, William Randall
Long, William Randall is an sole proprietor health care provider with primary practice located at 9602 E Washington St Suite C, Indianapolis IN 46229-4504. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Long, William Randall can be contacted via phone (317) 899-5437.Contact Information
Primary practice address
9602 E Washington St Suite C
Indianapolis IN 46229-4504
Phone: (317) 899-5437
Fax: (317) 897-0771
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 12006619 | Indiana |
Profile Details
| NPI number | 1598775868 |
|---|---|
| LBN Legal business name | Long, William Randall |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598775868 | NPPES |
| Indiana | Other | 429256 | UNITED CONCORDIA |
| Indiana | Other | 145620 | UNITED CONCORDIA |
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