Individual
LOGAN MACKEY FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1097 N JACKSONMILL AVE, KUNA, ID 83634-2086
(208) 519-7171
Mailing address
730 N KATIE WAY, KUNA, ID 83634-2161
(971) 203-3896
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5640
ID
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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