Individual
DR. LOGAN KLUDT LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2120 US-14 EAST, ROCHESTER, MN 55904-0002
(507) 258-7934
Mailing address
2120 US-14 EAST, ROCHESTER, MN 55904
(507) 258-7934
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14715
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D14715
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/01/2022
Last updated
04/25/2023
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