Individual
DR. JOHN C LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
264 S WILSON ST, CASPER, WY 82601-2942
(307) 234-3259
Mailing address
264 S WILSON ST, CASPER, WY 82601-2942
(307) 234-3259
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
493
WY
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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