Cathy Evans Longos
Dentist Endodontist
22a Glen Ed Professional Park
Glen Carbon
, Illinois 62034
Cathy Evans Longos
Dentist Endodontist
22a Glen Ed Professional Park
Glen Carbon
, Illinois 62034
(618) 656-7615
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About
Features
Specialties
- Dentist
- Endodontist
Languages spoken
- English
Location
First Address
- Cathy Evans Longos
- 22a Glen Ed Professional Park
- Glen Carbon, IL
- Zip : 62034
- Phone : (618) 656-7615
Second Address
- Cathy Evans Longos
- 22a Glen Ed Professional Park
- Glen Carbon, IL
- Zip : 62034
- Phone : (618) 656-7615
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 122300000X | Dentist | 019021729 | IL |
| Y | 1223E0200X | Endodontist | 021001620 | IL |
National Provider Identifier
| NPI | 1114088812 |
|---|---|
| Provider Name | Cathy Evans Longos |
| First Address | Glen Carbon, IL 62034 |
| Second Address | Glen Carbon, IL 62034 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/12/2006 |
| Last Update Date | 21/06/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.