| Edward M. Logan, Dds, Lc | |
|
9016 Phoenix Pkwy O Fallon MO 63368-4278 | |
| (636) 561-5445 | |
| Not Available |
| Full Name | Edward M. Logan, Dds, Lc |
|---|---|
| Speciality | Dentist |
| Location | 9016 Phoenix Pkwy, O Fallon, Missouri |
| Authorized Official Name and Position | Edward M. Logan (OWNER) |
| Authorized Official Contact | 6365615445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward M. Logan, Dds, Lc 7 Matterhorn Ct O Fallon MO 63366-4804 Ph: (314) 302-7100 | Edward M. Logan, Dds, Lc 9016 Phoenix Pkwy O Fallon MO 63368-4278 Ph: (636) 561-5445 |
| NPI Number | 1851448229 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851448229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2002002458 (Missouri) | Primary |
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