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Organization
TRACEY DENTAL
Active
Organization
TRACEY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORIAN R LONG DDS (OWNER)
(214) 250-3818
Entity
Organization
Contact information
Practice address
301 N CUSTER RD STE 110, MCKINNEY, TX 75071-4828
(214) 250-3818
Mailing address
389 N CUSTER RD, MCKINNEY, TX 75071-4705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760936181
TYPE 1 NPI
TX
Enumeration date
09/18/2018
Last updated
11/04/2024
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