Individual
MARKISHA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3718 GRUBER RD, FORT BRAGG, NC 28310-8934
(910) 396-1571
Mailing address
3718 GRUBER RD, FORT BRAGG, NC 28310-8934
(910) 396-1571
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
2902016124
MI
124Q00000X
Dental Hygienist
DH011158
GA
124Q00000X
Dental Hygienist
Primary
H007204
AZ
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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