Individual
LOGAN LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6321 S REDWOOD RD, SUITE 206, TAYLORSVILLE, UT 84123-6798
(801) 590-8694
Mailing address
6321 S REDWOOD RD, SUITE 206, TAYLORSVILLE, UT 84123-6798
(801) 590-8694
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9795445-9922
UT
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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