Edward M. Logan, DDS

NPI #1669670980 in O Fallon, Missouri

Provider Information

NPI Number: 1669670980
Entity Type: Individual
Name: Edward M. Logan, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 8, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 9016 PHOENIX PKWY
City: O Fallon
State: Missouri
ZIP Code: 63368-4278
Phone: (636) 561-5445

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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