| Cache Valley Oral & Facial Surgery, Inc. | |
|
1320 N 600 E Suite 3 Logan UT 84341-2431 | |
| (435) 752-5681 | |
| (435) 752-5744 |
| Full Name | Cache Valley Oral & Facial Surgery, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1320 N 600 E, Logan, Utah |
| Authorized Official Name and Position | Stuart D. Wilkinson (PARTNER) |
| Authorized Official Contact | 4357525681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cache Valley Oral & Facial Surgery, Inc. 1320 N 600 E Suite 3 Logan UT 84341-2431 Ph: (435) 752-5681 | Cache Valley Oral & Facial Surgery, Inc. 1320 N 600 E Suite 3 Logan UT 84341-2431 Ph: (435) 752-5681 |
| NPI Number | 1033497417 |
|---|---|
| Provider Enumeration Date | 08/02/2011 |
| Last Update Date | 08/02/2011 |
| Medicare PECOS PAC ID | 6901063841 |
|---|---|
| Medicare Enrollment ID | O20120206000398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033497417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 1396909924 (Utah) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 79545799924 (Utah) | Secondary |
| Provider Name | Michael S Wilkinson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1548320963 PECOS PAC ID: 5991962730 Enrollment ID: I20120813000186 |
Raymond Scott Hlavaty Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 E 200 No, Ste A, Logan, UT 84321 Phone: 435-753-2828 Fax: 435-753-3628 | |
Dr. Gary Foster Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E 200 N, Logan, UT 84321 Phone: 435-752-0300 | |
Sterling Endodontics Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 E 200 N Ste G, Logan, UT 84321 Phone: 435-753-7668 | |
Larry T Hogge Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1230 N 200 E, Logan, UT 84341 Phone: 435-752-4134 Fax: 435-752-1020 | |
M. Andrew Johnson D.d.s. Lc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1153 N Main St, Suite B-150, Logan, UT 84341 Phone: 435-752-2153 | |
Thomson Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1445 N 400 E Ste 3, Logan, UT 84341 Phone: 435-752-1320 Fax: 435-750-6432 |