Community Dental, INC

NPI #1245539808 in Brandon, Mississippi

Provider Information

NPI Number: 1245539808
Entity Type: Organization
Organization Name: Community Dental, INC
Primary Specialty: Dentist
Enumeration Date: Mar 22, 2011
Last Updated: Mar 22, 2011

Practice Location

Address: 908 MUNICIPAL DR
City: Brandon
State: Mississippi
ZIP Code: 39042-2973
Phone: (601) 825-2150

Authorized Official

Name: DR. JAMAAL EDWIN LONGINO, D.M.D.
Title: DENTIST/PRESIDENT
Phone: (601) 825-2150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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