Longevity Dental

NPI #1669989240 in Rockwall, Texas

Provider Information

NPI Number: 1669989240
Entity Type: Organization
Organization Name: Longevity Dental
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jan 5, 2018
Last Updated: Jan 5, 2018

Practice Location

Address: 510 TURTLE COVE BLVD STE 107
City: Rockwall
State: Texas
ZIP Code: 75087-5374
Phone: (972) 771-0977

Authorized Official

Name: RONALD G EVANS
Title: SOLE MBR
Phone: (972) 771-0977

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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