Individual
LOGAN PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
104 S WALTON BLVD, BENTONVILLE, AR 72712-5747
(479) 273-3757
Mailing address
400 RIVERWALK TER STE 250, JENKS, OK 74037-5619
(918) 988-0996
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4421
AR
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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