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Individual

DENNIS WAYNE LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BS PHARMACY

Contact information

Practice address
200 TECHNOLOGY CT SE, SUITE B, SMYRNA, GA 30082-5250
(770) 437-8040
(770) 437-8411
Mailing address
200 TECHNOLOGY CT SE, SUITE B, SMYRNA, GA 30082-5250
(770) 437-8040
(770) 437-8411

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH016522
GA

Other

Enumeration date
09/29/2016
Last updated
09/29/2016
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