Individual
DR. LOGAN MARIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4383 E ROSEMONTE DR, PHOENIX, AZ 85050-3407
(570) 772-3267
Mailing address
4383 E ROSEMONTE DR, PHOENIX, AZ 85050-3407
(570) 772-3267
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D010364
AZ
Other
Enumeration date
04/21/2018
Last updated
07/19/2019
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