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Individual

DEBORAH ANNE LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRDH

Contact information

Practice address
7973 W DESTINY BLVD, FORT CAMPBELL, KY 42223-5429
(270) 412-6027
Mailing address
7973 W DESTINY BLVD, FORT CAMPBELL, KY 42223-5429
(270) 412-6027

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH12084
FL

Other

Enumeration date
11/13/2018
Last updated
03/16/2026
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