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General NPI Number Information
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NPI Number | 1255221263
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Entity Type | Individual
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Provider Name | LOGAN ALEXANDER MARKS DMD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 8930 R G SKINNER PKWY 8930 R G SKINNER PARKWAY
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City | JACKSONVILLE
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State | FL
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Zip | 32256-4020
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Country | US
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Telephone | 904-645-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 1068 KINGS RD
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-3263
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Country | US
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Telephone | 904-710-6505
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN30531
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License Number State | FL
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