DR. Polly Jo Courtney Logan, DDS

NPI #1043221153 in Stillwater, Minnesota

Provider Information

NPI Number: 1043221153
Entity Type: Individual
Name: DR. Polly Jo Courtney Logan, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Aug 11, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 13961 60TH ST
Address 2: ST CROIX VALLEY DENTAL
City: Stillwater
State: Minnesota
ZIP Code: 55082
Phone: (651) 439-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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