Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223X0400X | Orthodontists | 0401412540 | VA |
Y | 1223X0400X | Orthodontists | 15804 | MD |
NPI | 1033348032 |
---|---|
Provider Name | Dr. Besi Long Tong |
First Address | Alexandria, VA 22310-2627 |
Second Address | Waldorf, MD 20602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2009 |
Last Update Date | 13/07/2018 |