Longmeadow Family Dental Care

NPI #1174637185 in Hagerstown, Maryland

Provider Information

NPI Number: 1174637185
Entity Type: Organization
Organization Name: Longmeadow Family Dental Care
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 18, 2006
Last Updated: Nov 8, 2017

Practice Location

Address: 19638 LEITERSBURG PIKE
Address 2: SUITE 103
City: Hagerstown
State: Maryland
ZIP Code: 21742
Phone: (301) 739-1100

Authorized Official

Name: DR. BRANDON KEITH ELLIS, DDS
Title: PRES/OWNER
Phone: (301) 739-1100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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