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Contact Information

LOGAN ORAL SURGERY
3125 N. MAIN STREET
STE #103
NORTH LOGAN, UT84341-1550
 Phone: 435-754-7130
 Fax: 435-535-2464
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral and Maxillofacial Surgery

261QS0112X
Indicates primary specialty

NPI Profile & details for LOGAN ORAL SURGERY

NPI # 1598024341
LBN Legal business name LOGAN ORAL SURGERY
Authorized official SCOTT MATSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/15/2012
Last updated 04/28/2014 - About 12 years ago
Identifiers
UT License # 8227102-9924
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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