Individual
JULIE M LONGORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
11455 FALLBROOK DR STE 202, HOUSTON, TX 77065-4267
(281) 890-7475
Mailing address
11455 FALLBROOK DR STE 202, HOUSTON, TX 77065-4267
(281) 890-7475
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0023928
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210812801
—
TX
Enumeration date
07/09/2008
Last updated
01/12/2012
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