Individual
CASEY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1745 CITY CENTER BLVD STE A, ELIZABETH CITY, NC 27909-8953
(252) 331-2304
(888) 975-6590
Mailing address
1745 CITY CENTER BLVD STE A, ELIZABETH CITY, NC 27909-8953
(252) 331-2304
(888) 975-6590
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11199
NC
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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