Organization
CDA PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOGAN LOCKE DDS (DENTIST/OWNER)
(801) 755-9243
Entity
Organization
Contact information
Practice address
11978 S 700 E STE 101, DRAPER, UT 84020-9818
(801) 352-7002
Mailing address
11978 S 700 E STE 101, DRAPER, UT 84020-9818
(801) 352-7002
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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