Individual
TEMICKA LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1037 W MAIN ST STE E, LEBANON, TN 37087-3356
(615) 444-2262
Mailing address
1005 DR DB TODD JR BLVD, MEHARRY MEDICAL COLLEGE, NASHVILLE, TN 37208-3501
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0000010434
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2016
Last updated
01/13/2022
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