Organization
LONGO DENTAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA LOURDES LONGO D.M.D. (PRESIDENT)
(617) 738-7210
Entity
Organization
Contact information
Practice address
1037 BEACON ST APT 2, BROOKLINE, MA 02446-5640
(617) 738-7210
(617) 738-2930
Mailing address
1037 BEACON ST APT 2, BROOKLINE, MA 02446-5640
(617) 738-7210
(617) 738-2930
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0017181
MA
1223G0001X
General Practice Dentistry
21390
MA
1223P0300X
Periodontics
18432
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
17415
MA
Other
Enumeration date
02/15/2008
Last updated
02/15/2008
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