Provider Demographics
NPI:1992552392
Name:LOGRONIO, JANELLE (DMD)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:LOGRONIO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 W 2ND ST APT 21
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-4748
Mailing Address - Country:US
Mailing Address - Phone:904-303-3075
Mailing Address - Fax:
Practice Address - Street 1:193 BOSTON TPKE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-2549
Practice Address - Country:US
Practice Address - Phone:508-669-7140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN10000997122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist