| Ethan Long Dds Pllc | |
|
1105 E Lamar Alexander Pkwy Maryville TN 37804-5130 | |
| (865) 984-7757 | |
| (865) 724-2272 |
| Full Name | Ethan Long Dds Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1105 E Lamar Alexander Pkwy, Maryville, Tennessee |
| Authorized Official Name and Position | Janet Latham (OFFICE MANAGER) |
| Authorized Official Contact | 8659847757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan Long Dds Pllc 1105 E Lamar Alexander Pkwy Maryville TN 37804-5130 Ph: (865) 984-7757 | Ethan Long Dds Pllc 1105 E Lamar Alexander Pkwy Maryville TN 37804-5130 Ph: (865) 984-7757 |
| NPI Number | 1376329094 |
|---|---|
| Provider Enumeration Date | 09/07/2023 |
| Last Update Date | 09/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376329094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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