Most Relevant Information
Provider Data
| NPI Number: | 1003509159 |
| Provider Name: | LOGAN ALEXANDER WOOD DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 2901601718 |
Most Important Dates
| Enumeration Date: | 06/02/2023 |
| Last Updated: | 06/02/2023 |
Provider Practice Location
932 SPRING ST STE 102
PETOSKEY
MI
497702286
Practice Location Phone/Fax
| Phone: | 2316468005 |
| Fax: |
Provider Mailing Location
410 W LAKE ST
PETOSKEY
MI
497702267
Provider Mailing Phone/Fax
| Phone: | 2486227434 |
| Fax: |