Alexandria Old Town Dental Pllc

NPI #1518465939 in Alexandria, Virginia

Provider Information

NPI Number: 1518465939
Entity Type: Organization
Organization Name: Alexandria Old Town Dental Pllc
Primary Specialty: Dentist
Enumeration Date: Jan 31, 2018
Last Updated: Sep 8, 2020

Practice Location

Address: 1421 PRINCE ST STE 140
City: Alexandria
State: Virginia
ZIP Code: 22314-2771
Phone: (703) 549-1331

Authorized Official

Name: DR. EDDIE SEYMOUR LONGMAN, DDS
Title: DENTIST/OWNER
Phone: (703) 549-1331

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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