Individual
CHRISTOPHER R LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
137 WESTERN AVE, AUGUSTA, ME 04330-7236
(207) 622-3879
Mailing address
137 WESTERN AVE, AUGUSTA, ME 04330-7236
(207) 622-3879
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN4625
ME
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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