Individual
DR. LOGAN D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12123 PACIFIC ST, OMAHA, NE 68154-3527
(402) 334-4422
Mailing address
12123 PACIFIC ST, OMAHA, NE 68154-3527
(402) 334-4422
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7934
NE
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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