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:
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Health care specialties

SpecialtyCodeLicense #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 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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Identifiers

StateTypeNumberIssuer
All States NPI 1598775868 NPPES
Indiana Other 429256 UNITED CONCORDIA
Indiana Other 145620 UNITED CONCORDIA

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