LOGAN ORAL SURGERY (NPI# 1598024341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598024341 |
| Entity Type | Organization |
| Organization Name | LOGAN ORAL SURGERY |
| Practice Address |
3125 N. Main Street Ste #103 North Logan UT 84341-1550 |
| Practice Telephone | 4357547130 |
| Practice Fax Number | 4355352464 |
| Mailing Telephone | 4357547130 |
| Mailing Fax Number | 4355352464 |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2014-04-28 |
| Authorized Official Name | DR. SCOTT MATSON (OWNER) |
| Authorized Official Telephone | 4357547130 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
8227102-9924 | UT | Ambulatory Health Care Facilities |
| Street Address |
3125 N. MAIN STREET STE #103 |
| City | NORTH LOGAN |
| State | UT |
| Zip Code | 84341-1550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912507153 | Legacy Heights Oral & Facial Surgery Pllc | Clinic/Center | 193 S 200 W Ste B, Farmington, UT 84025-2406 | 2020-10-27 |
| 1962038711 | Stanley Oral & Facial Surgery Pllc | Clinic/Center | 3632 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7163 | 2020-03-12 |
| 1851937270 | Randy Sean Barnhisel Dds, Pllc | Clinic/Center | 4970 S 900 E Ste G, Salt Lake City, UT 84117-3930 | 2019-11-20 |
| 1558744748 | Ryan K Austin, Dds PC | Clinic/Center | 5742 S 1475 E Ste 100, South Ogden, UT 84403-4857 | 2015-07-07 |
| 1821400532 | Southwest Oral and Facial Surgery Inc | Clinic/Center | 11748 S 3600 W, Suite 1, South Jordan, UT 84095-5922 | 2014-05-29 |
| 1376827832 | Dustin J Hopkin Dds, Oral and Maxillofacial Surgery P.C. | Clinic/Center | 2180 E 4500 S Ste 285, Salt Lake City, UT 84117-4028 | 2011-10-03 |
| 1275722357 | Utah Surgical Arts | Clinic/Center | 3610 N University Ave, Suite 150, Provo, UT 84604-4437 | 2007-10-15 |
| City | NORTH LOGAN |
| Zip Code | 84341 |
Please comment or provide details below to improve the information on LOGAN ORAL SURGERY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.