IndividualActive
Bradley Logie, DDS
NPI 1073707519 · Oral and Maxillofacial Surgery (Dentist) · Fort Sill, OK
Provider details
- NPI number
- 1073707519
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- L117008 (MI)
Specialties & taxonomies
Dental Providers
Practice location
2776 Ringgold Road
Attn: Credentials Coordinator
Fort Sill, OK 73503-6300
Phone: (580) 442-3905
Fax: (580) 442-4002
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 268819
Oklahoma City, OK 73126-8819
Registry dates
- Enumerated
- 2007-08-28
- Last updated
- 2019-01-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.