Organization
MICHAEL P. LOGUE, D.M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL P LOGUE D.M.D. (PRESIDENT/ORAL SURGEON)
(954) 941-2727
Entity
Organization
Contact information
Practice address
1800 N FEDERAL HWY, SUITE 201, POMPANO BEACH, FL 33062-1034
(954) 941-2727
(954) 941-1116
Mailing address
1800 N FEDERAL HWY, SUITE 201, POMPANO BEACH, FL 33062-1034
(954) 941-2727
(954) 941-1116
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DN12346
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071462300
—
FL
Enumeration date
09/01/2010
Last updated
09/01/2010
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