Individual
DR. RONALD WILLIAM LOGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4622 COUNTRY CLUB RD, SUITE 240, WINSTON SALEM, NC 27104
(336) 760-9400
(336) 760-0963
Mailing address
4622 COUNTRY CLUB RD, SUITE 240, WINSTON SALEM, NC 27104
(336) 760-9400
(336) 760-0963
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5824
NC
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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