Provider Demographics
NPI:1194086744
Name:WEBB, LOGAN ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:ELIZABETH
Last Name:WEBB
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 1:3125 SPRINGBANK LN STE E
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3379
Mailing Address - Country:US
Mailing Address - Phone:704-980-0545
Mailing Address - Fax:704-980-0545
Practice Address - Street 1:3125 SPRINGBANK LN STE E
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3379
Practice Address - Country:US
Practice Address - Phone:704-980-0545
Practice Address - Fax:704-980-0545
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9319122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist