Individual
DR. JONATHAN LOGAN CHRISIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
311 PETE PHILLIPS DR, VIDALIA, GA 30474-8821
(912) 537-7048
(912) 537-7058
Mailing address
311 PETE PHILLIPS DR, VIDALIA, GA 30474-8821
(912) 537-7048
(912) 537-7058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122426
GA
Other
Enumeration date
07/15/2021
Last updated
08/10/2021
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