Organization
RAYMOND SCOTT HLAVATY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND SCOTT HLAVATY DMD MS (PRESIDENT OWNER)
(435) 753-2828
Entity
Organization
Contact information
Practice address
150 E 200 NO, STE A, LOGAN, UT 84321
(435) 753-2828
(435) 753-3628
Mailing address
150 E 200 NO, STE A, LOGAN, UT 84321
(435) 753-2828
(435) 753-3628
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
932604579921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528170323003
—
UT
Enumeration date
11/30/2006
Last updated
07/30/2008
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