Individual
DR. JON LAURENCE LOGULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
411 W COLLEGE AVE, GREENVILLE, IL 62246-1020
(618) 664-2236
(618) 664-0386
Mailing address
P. O. BOX 398, GREENVILLE, IL 62246-6224
(618) 664-2236
(618) 664-0386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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