Individual
DR. CEMERON LAVAR LONGSTREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3903 AUGUSTA RD, PIEDMONT DENTAL CENTER, GREENVILLE, SC 29605-1337
(864) 299-6700
Mailing address
620 HALTON RD APT 8102, GREENVILLE, SC 29607-3466
(864) 234-7461
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4331
SC
Other
Enumeration date
06/25/2007
Last updated
06/28/2010
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