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Individual
DR. LOGAN KLUDT LAWRENCE
Active
Individual
DR. LOGAN KLUDT LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8194
NE
122300000X
Dentist
Primary
D14715
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D14715
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/01/2022
Last updated
09/02/2026
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