Individual
CAITLYN STOUDER LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2333 SPARTA WAY, BUFORD, GA 30519-2000
(770) 637-1873
Mailing address
2333 SPARTA WAY, BUFORD, GA 30519-2000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN016060
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/16/2020
Last updated
05/15/2024
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