Individual
DR. LOGAN NALLEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3643 WALTON WAY EXT, BLDG. 1, AUGUSTA, GA 30909-4507
(706) 733-8641
(706) 733-8615
Mailing address
3643 WALTON WAY EXT, BLDG. 1, AUGUSTA, GA 30909-4507
(706) 733-8641
(706) 733-8615
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013798
GA
Other
Enumeration date
03/24/2010
Last updated
03/24/2010
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