Provider Demographics
NPI:1336152867
Name:LOGAN, LORI HUNT (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:HUNT
Last Name:LOGAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11808 BARKER CYPRESS RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2291
Mailing Address - Country:US
Mailing Address - Phone:281-256-6866
Mailing Address - Fax:
Practice Address - Street 1:11808 BARKER CYPRESS RD
Practice Address - Street 2:SUITE G
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2291
Practice Address - Country:US
Practice Address - Phone:281-256-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice