THEODORE LOGAN JR., DMD

Dentist - Oral and Maxillofacial Surgery

Active Individual
NPI: 1245231778

Practice Address

3101 BRECKENRIDGE LN
STE 2D
Louisville, KY 40220

Phone: (502) 459-8012

Specialties

Specialty Code Primary License
Dentist - Oral and Maxillofacial Surgery 1223S0112X Yes 4056 (KY)

Frequently Asked Questions

NPI 1245231778 is the National Provider Identifier for THEODORE LOGAN JR., DMD, a Dentist - Oral and Maxillofacial Surgery provider located in Louisville, KY. This NPI was enumerated on August 9, 2005.
THEODORE LOGAN JR., DMD practices at 3101 BRECKENRIDGE LN, STE 2D, Louisville, KY 40220.

Quick Facts

NPI
1245231778
Type
Individual
Enumerated
Aug 9, 2005
Last Updated
Jul 8, 2007

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