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1871155747
LOGAN A MALLICOAT
KANSAS CITY, MO
NPI
1871155747
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: MO 2019024183)
Enumeration Date
2019-07-01
Last Update Date
2019-07-01
Business Address
Dr. LOGAN A MALLICOAT DDS
209 NE BARRY RD
KANSAS CITY, MO 64155-2721
Phone number: 816-454-6443
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Mailing Address
Dr. LOGAN A MALLICOAT DDS
715 ARMOUR RD APT 112
KANSAS CITY, MO 64116-3637
Phone number: 913-972-7545
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