# UPSTATE ORAL SURGERY AND DENTAL IMPLANTS, PLLC

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

## Provider details

- **NPI number:** 1952864548
- **Authorized official:** LOGAN RAND CURTIS DDS (DR)
- **Authorized official phone:** (910) 973-1754

## Contact information

- **Practice address:** 22632 SUMMIT DR STE B, WATERTOWN, NY 13601-7233
- **Practice address phone:** (315) 405-4005
- **Mailing address:** 22632 SUMMIT DR STE B, WATERTOWN, NY 13601-7233
- **Mailing address phone:** (315) 405-4005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2019
- **Last updated:** 04/10/2019