Individual
DR. JAMAAL EDWIN LONGINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
105 RIDGE WAY, STE, FLOWOOD, MS 39232-3303
(601) 203-1654
Mailing address
105 RIDGE WAY, STE, FLOWOOD, MS 39232-3303
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3483-08
MS
Other
Enumeration date
07/10/2008
Last updated
04/25/2017
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