Organization
LOGAN NALLEY III, D.M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOGAN NALLEY III DR (DMD/OWNER)
(803) 716-8434
Entity
Organization
Contact information
Practice address
1961 WHISKEY RD, AIKEN, SC 29803-7603
(803) 716-8434
(803) 648-9183
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
(315) 410-5531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8190
SC
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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