NPI 1205090040

Jamaal Edwin Longino, DMD

Practitioner Dentist Flowood, MS

Practice location

Address: 105 Ridge Way STE, Flowood, MS 39232-3303
Phone: (601) 203-1654

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 3483-08 (MS)

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Registry record

NPI: 1205090040
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Jul 2008
Record last updated: 25 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.