THEODORE E LOGAN

LOUISVILLE, KY
NPI1245231778
Entity TypeIndividual
GenderMale
Sole Proprietor ?
Primary Taxonomy1223S0112X Dentist Oral and Maxillofacial Surgery
(Licence: KY  4056)
Enumeration Date2005-08-09
Last Update Date2007-07-08
Business Address
THEODORE E LOGAN DMD
3101 BRECKENRIDGE LN STE 2D
LOUISVILLE, KY 40220-2742
Phone number: 502-459-8012
Mailing Address
THEODORE E LOGAN DMD
3101 BRECKENRIDGE LN STE 2D
LOUISVILLE, KY 40220-2742
Phone number: 502-459-8012
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