Provider Demographics
NPI:1255221263
Name:MARKS, LOGAN ALEXANDER (DMD)
Entity type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:ALEXANDER
Last Name:MARKS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32266-3263
Mailing Address - Country:US
Mailing Address - Phone:904-710-6505
Mailing Address - Fax:
Practice Address - Street 1:8930 R G SKINNER PKWY
Practice Address - Street 2:8930 R G SKINNER PARKWAY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-4020
Practice Address - Country:US
Practice Address - Phone:904-645-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN30531122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist