Organization
SOPHIE LOGAN DDS MMSC PC
Active
Other names
Sea Glass Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIE LOGAN DDS, MMSC (ORTHODONTIST)
(831) 531-7660
Entity
Organization
Contact information
Practice address
824 MISSION ST, SANTA CRUZ, CA 95060-3681
(707) 849-3113
Mailing address
115 SEGRE PL, SANTA CRUZ, CA 95060-3160
(831) 331-1903
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
02/07/2025
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