Organization
ROBERT D. HAZEN D.D.S., PC
Active
Other names
Robert D. Hazen D.D.S., P.C
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DEAN HAZEN DDS (DENTIST)
(801) 295-5586
Entity
Organization
Contact information
Practice address
460 S 400 E, BOUNTIFUL, UT 84010-4975
(801) 295-5586
Mailing address
460 S 400 E, BOUNTIFUL, UT 84010-4975
(801) 295-5586
(801) 292-5342
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
130257-9921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130257-9921
STATE LICENSE INFORMATION
UT
Enumeration date
04/05/2007
Last updated
08/22/2020
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