Lee R. Logan, D.d.s., Prof. Corp.

NPI #1003869769 in Northridge, California

Provider Information

NPI Number: 1003869769
Entity Type: Organization
Organization Name: Lee R. Logan, D.d.s., Prof. Corp.
Primary Specialty: Dentist
Enumeration Date: May 17, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 18250 ROSCOE BLVD
Address 2: SUITE #315
City: Northridge
State: California
ZIP Code: 91325-4226
Phone: (818) 885-8650

Authorized Official

Name: DR. LEE ROBERT LOGAN, D.D.S.,M.S.
Title: PRESIDENT
Phone: (818) 885-8650

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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