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General NPI Number Information
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NPI Number | 1124657382
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Entity Type | Individual
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Provider Name | LOGAN MICHAEL DILIK DDS
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Gender | Male
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 26179 DETROIT RD
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City | WESTLAKE
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State | OH
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Zip | 44145-2430
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Country | US
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Telephone | 440-583-6677
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Fax |
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Provider Business Mailing Address
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Address Line | 184 MOOREWOOD AVE
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City | AVON LAKE
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State | OH
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Zip | 44012-1418
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Country | US
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Telephone | 440-714-2479
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 30.026104
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License Number State | OH
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