Individual
KELBE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-5514
Mailing address
761 RICE RD APT 319, RIDGELAND, MS 39157-1089
(662) 739-8428
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4493-25
MS
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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