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Individual
LOGAN CORNWELL
Active
Individual
LOGAN CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010936
AZ
1223G0001X
General Practice Dentistry
DEN.00204475
CO
Other
Enumeration date
05/19/2020
Last updated
04/09/2024
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