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Individual

DR. LOGAN B EBERSOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
200 N DOBYS BRIDGE RD STE 108, FORT MILL, SC 29715-2084
(803) 396-5888
(803) 396-5896
Mailing address
200 N DOBYS BRIDGE RD STE 108, FORT MILL, SC 29715-2084
(803) 396-5888
(803) 396-5893

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4618
SC

Other

Enumeration date
07/02/2009
Last updated
05/20/2021
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