Healthcare Provider Details

I. General information

NPI: 1073439147
Provider Name (Legal Business Name): LOGAN SPANEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 N OAKLAND AVE
OAKLAND NE
68045-1339
US

IV. Provider business mailing address

228 N OAKLAND AVE
OAKLAND NE
68045-1339
US

V. Phone/Fax

Practice location:
  • Phone: 402-685-5677
  • Fax: 402-685-6863
Mailing address:
  • Phone: 402-685-5677
  • Fax: 402-685-6863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8224
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: