Individual
KELLI G LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1211 CORTINA DR, ORLAND, CA 95963-1699
(530) 865-5561
(530) 865-4730
Mailing address
PO BOX A D, YUBA CITY, CA 95992-1396
(530) 751-3769
(530) 751-1237
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
11817
CA
Other
Enumeration date
03/20/2008
Last updated
07/01/2011
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