Individual
DR. MACKENZIE GRACE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
129 PLANTATION NORTH BLVD STE D, GOOSE CREEK, SC 29445-5776
(843) 410-4920
Mailing address
400 MEMORIAL DRIVE EXT STE 400, GREER, SC 29651-1850
(864) 282-1935
(864) 751-6387
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DGD.10514
SC
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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