| Timothy W. Logan, D.m.d., P.s.c. | |
|
9800 Shelbyville Rd Suite 202 Louisville KY 40223-5440 | |
| (502) 429-0526 | |
| (502) 429-0532 |
| Full Name | Timothy W. Logan, D.m.d., P.s.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 9800 Shelbyville Rd, Louisville, Kentucky |
| Authorized Official Name and Position | Timothy Wilson Logan (OWNER) |
| Authorized Official Contact | 5024290526 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy W. Logan, D.m.d., P.s.c. 9800 Shelbyville Road Suite 202 Louisville KY 40223-5440 Ph: (502) 429-0526 | Timothy W. Logan, D.m.d., P.s.c. 9800 Shelbyville Rd Suite 202 Louisville KY 40223-5440 Ph: (502) 429-0526 |
| NPI Number | 1427349687 |
|---|---|
| Provider Enumeration Date | 04/22/2011 |
| Last Update Date | 04/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427349687 | NPI | - | NPPES |
| 1548227655 | Other | NPI TYPE 1 | |
| 000000049874 | Other | BLUE CROSS/BLUE SHIEL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5015 (Kentucky) | Primary |
Bardstown Road Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5300 Bardstown Rd, Louisville, KY 40291 Phone: 502-493-0302 | |
Mortenson Family Dental Center - Dixie At Rockford Lane, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4740 Dixie Hwy, Louisville, KY 40216 Phone: 502-447-8992 | |
Bbb - Fern Creek Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9360 Cedar Center Way, Louisville, KY 40291 Phone: 502-239-9070 Fax: 502-239-9078 | |
Tds Ky Five Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 Thierman Ln, Louisville, KY 40207 Phone: 502-896-2822 | |
Dental Health Professionals Of Kentucky, P.s.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7704 Bardstown Rd, Louisville, KY 40291 Phone: 502-200-5220 | |
Advanced Dental Center, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8517 Preston Hwy, Louisville, KY 40219 Phone: 502-966-4367 Fax: 502-966-4001 | |
Drs. Graham And Fortune, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9001 Galene Dr, Louisville, KY 40299 Phone: 502-267-8176 Fax: 502-267-8177 |