Dorian Grace Longshore, DMD

NPI #1104355395 in Loganville, Georgia

Provider Information

NPI Number: 1104355395
Entity Type: Individual
Name: Dorian Grace Longshore, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Jun 9, 2017
Last Updated: Jun 9, 2017

Practice Location

Address: 4799 ATLANTA HWY # 500
City: Loganville
State: Georgia
ZIP Code: 30052-7307
Phone: (404) 609-4661

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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