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GREGORY GEORGE LONG DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1124376660

Individual Registrant:
 GREGORY GEORGE LONG DDS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
209 BIRCH STREET  WESTWOOD, CA 96137 US
Tel: 530-256-3152  Fax: --

Contact information for business:
916 CLIFFORD DRIVE  LAKE ALMANOR, CA 96137 US
Tel: 530-259-4536  Fax: --

Registration Information:
NPI: 1124376660
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
CA21475

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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