Logansmiles LLC

NPI #1376017806 in Logan, Utah

Provider Information

NPI Number: 1376017806
Entity Type: Organization
Organization Name: Logansmiles LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 17, 2019
Last Updated: Jan 17, 2019

Practice Location

Address: 1340 N 600 E STE 1
City: Logan
State: Utah
ZIP Code: 84341-2475
Phone: (435) 752-2230

Authorized Official

Name: DR. SCOTT LAKE THEURER, DMD
Title: MANAGER, OWNER DENTIST
Phone: (435) 752-2230

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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