Individual
DR. RICKY WARNER LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4711 ATLANTA HWY, MONTGOMERY, AL 36109-3240
(334) 272-6880
Mailing address
4711 ATLANTA HWY, MONTGOMERY, AL 36109-3240
(334) 272-6880
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4104
AL
Other
Enumeration date
04/14/2008
Last updated
04/14/2008
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