Individual
LOGAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
77 ELM ST, PITTSFIELD, MA 01201-6503
(413) 442-0122
Mailing address
29 WESTVIEW RD, LANESBOROUGH, MA 01237-9516
(413) 841-2094
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN1859678
MA
Other
Enumeration date
04/11/2021
Last updated
07/11/2023
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