Individual
DR. LOGAN NALLEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3643 WALTON WAY EXT, AUGUSTA, GA 30909-4507
(706) 733-8641
(706) 733-8615
Mailing address
3643 WALTON WAY EXT, AUGUSTA, GA 30909-4507
(706) 733-8641
(706) 733-8615
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
2237
SC
1223P0700X
Prosthodontics
Primary
8956
GA
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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