| Theodore E Logan Jr, DMD | |
|
3101 Breckenridge Ln, Ste 2d, Louisville, KY 40220-2742 | |
| (502) 459-8012 | |
| (502) 459-8021 |
| Full Name | Theodore E Logan Jr |
|---|---|
| Gender | Male |
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3101 Breckenridge Ln, Louisville, Kentucky |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245231778 | NPI | - | NPPES |
| 64040561 | Medicaid | KY | |
| 1055007 | Other | KY | PASSPORT |
| 60040565 | Other | KY | MEDICAID DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4056 (Kentucky) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Theodore E Logan Jr, DMD 3101 Breckenridge Ln, Ste 2d, Louisville, KY 40220-2742 Ph: (502) 459-8012 | Theodore E Logan Jr, DMD 3101 Breckenridge Ln, Ste 2d, Louisville, KY 40220-2742 Ph: (502) 459-8012 |
Mary Margaret Lee, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 400 E Gray St, Louisville, KY 40202 Phone: 502-574-6511 | |
Dr. Lan Tuyet Tran, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 10494 Westport Rd, Suite 107, Louisville, KY 40241 Phone: 502-365-9699 | |
Dr. Jeffrey Hedges, DMD Dentist Medicare: Medicare Enrolled Practice Location: 2015 Herr Ln Ste D, Louisville, KY 40222 Phone: 502-767-7379 | |
Stephanie N Luckett, DMD Dentist Medicare: Medicare Enrolled Practice Location: 2215 Portland Ave, Louisville, KY 40212 Phone: 502-772-8160 Fax: 502-772-8108 | |
Dr. Niyati Kapadia, Dentist Medicare: Not Enrolled in Medicare Practice Location: 401 E Chestnut St Unit 550, Louisville, KY 40202 Phone: 502-852-5401 | |
Dr. Scott Mcgee Taylor, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 3801 S Hurstbourne Pkwy, Louisville, KY 40299 Phone: 502-709-9430 | |
Lakynn Alexis Hodgens, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 3946 Taylorsville Rd, Louisville, KY 40220 Phone: 502-895-2218 |