Organization
ROBERT DICTROW DDS, BRUCE S. LOGUE DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE S. LOGUE D.D.S. (VP)
(631) 273-0988
Entity
Organization
Contact information
Practice address
652 SUFFOLK AVENUE, BRENTWOOD, NY 11717
(631) 273-0988
(631) 273-0949
Mailing address
652 SUFFOLK AVENUE, BRENTWOOD, NY 11717
(631) 273-0988
(631) 273-0949
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
029219
NY
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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