# LOGAN NALLEY III, D.M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568905099
- **Authorized official:** LOGAN NALLEY III DR (DMD/OWNER)
- **Authorized official phone:** (803) 716-8434

## Contact information

- **Practice address:** 1961 WHISKEY RD, AIKEN, SC 29803-7603
- **Practice address phone:** (803) 716-8434
- **Practice address fax:** (803) 648-9183
- **Mailing address:** PO BOX 3189, SYRACUSE, NY 13220-3189
- **Mailing address phone:** (315) 454-6000
- **Mailing address fax:** (315) 410-5531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8190 | SC | Yes |

## Other

- **Enumeration date:** 12/01/2016
- **Last updated:** 12/01/2016