Provider Demographics
NPI:1669988028
Name:LONGWITH, EMILY LOUISE (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:LOUISE
Last Name:LONGWITH
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18706 CAPETOWN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-4015
Mailing Address - Country:US
Mailing Address - Phone:317-644-1045
Mailing Address - Fax:
Practice Address - Street 1:1011 AUGUSTA DR STE 203
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-2061
Practice Address - Country:US
Practice Address - Phone:713-781-4457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311801223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics