=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083578967
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCOTT A. LOGAN D.D.S., AND AARON D. FRITSCH D.D.S., PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2025
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3205 ROBINSON CREEK PKWY
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77340-2299
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-291-6589
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3205 ROBINSON CREEK PKWY
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77340-2299
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-291-6589
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AARON FRITSCH
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 936-291-6589
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------