Individual
DR. GERALD DENNIS LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3116 ACACIA DRIVE, CHEYENNE, WY 82001-5804
(307) 634-3488
Mailing address
3116 ACACIA DRIVE, CHEYENNE, WY 82001-5804
(307) 634-3488
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
611
WY
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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