Individual
DR. LOGAN JOE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
208 N WASHINGTON ST, TULLAHOMA, TN 37388-3649
(931) 455-3917
Mailing address
4 IVY DR, FAYETTEVILLE, TN 37334-7287
(931) 644-5764
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12192
TN
Other
Enumeration date
05/15/2023
Last updated
05/23/2023
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