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Individual
BENJAMIN LONGO
Active
Individual
BENJAMIN LONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12204
NC
1223G0001X
General Practice Dentistry
Primary
DN1859652
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
03/31/2020
Last updated
10/28/2024
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