Individual
DR. GENE FREDRICK LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11066 5TH AVE NE, SUITE 203, SEATTLE, WA 98125-6156
(206) 361-9869
(206) 361-1156
Mailing address
11066 5TH AVE NE, SUITE 203, SEATTLE, WA 98125-6156
(206) 361-9869
(206) 361-1156
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00004514
WA
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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