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Organization

LOGAN ORAL SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SCOTT MATSON D.M.D. (OWNER)
(435) 754-7130
Entity
Organization

Contact information

Practice address
3125 N. MAIN STREET, STE #103, NORTH LOGAN, UT 84341-1550
(435) 754-7130
(435) 535-2464
Mailing address
3125 N. MAIN STREET, STE #103, NORTH LOGAN, UT 84341-1550
(435) 754-7130
(435) 535-2464

Taxonomy

Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
8227102-9924
UT

Other

Enumeration date
05/15/2012
Last updated
04/28/2014
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