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1073707519
BRADLEY DWIGHT LOGIE
FORT SILL, OK
NPI
1073707519
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: MI L117008)
Enumeration Date
2007-08-28
Last Update Date
2019-01-07
Business Address
Dr. BRADLEY DWIGHT LOGIE DDS
2776 RINGGOLD ROAD ATTN: CREDENTIALS COORDINATOR
FORT SILL, OK 73503-6300
Phone number: 580-442-3905
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Mailing Address
Dr. BRADLEY DWIGHT LOGIE DDS
PO BOX 268819
OKLAHOMA CITY, OK 73126-8819
Phone number: 269-556-9398
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