MEDICARE: DR. MARC LONGE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901603020	MI

General Provider Information

NPI Number	:	1902739154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC LONGE DDS

Provider Business Mailing Address
First Line	:	8320 GREEN RD
Second Line	:
City	:	FENTON
State	:	MI
Zip	:	48430-9037
Country	:	US
Telephone Number	:	810-355-5702
Fax Number	:

Provider Business Practice Location Address
First Line	:	8320 GREEN RD
Second Line	:
City	:	FENTON
State	:	MI
Zip	:	48430-9037
Country	:	US
Telephone Number	:	810-355-5702
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2026
Last Update Date	:	06/06/2026

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