Logelin, Michael Gregory
Logelin, Michael Gregory is an individual health care provider with primary practice located at Bldg 45005 Runion Dental Clinic Usa Dentac, Ft Huachuca AZ 85670. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Logelin, Michael Gregory can be contacted via phone (520) 533-3144.Contact Information
Primary practice address
Bldg 45005 Runion Dental Clinic Usa Dentac
Ft Huachuca AZ 85670
Phone: (520) 533-3144
Fax: (520) 533-7285
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 28353 | California |
| Dental Providers / General Practice | 1223G0001X | 3481 | Nevada |
| Dental Providers / General Practice | 1223G0001X | 9858 | Colorado |
Profile Details
| NPI number | 1841210572 |
|---|---|
| LBN Legal business name | Logelin, Michael Gregory |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Nov 27th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841210572 | NPPES |
| Colorado | MEDICAID | 32170513 | |
| Colorado | MEDICAID | D28353 | |
| Colorado | MEDICAID | 002202771 |
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