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Individual

RAYMOND SCOTT HLAVATY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
150 E 200 N STE A, LOGAN, UT 84321-4036
(435) 753-2828
(435) 753-3628
Mailing address
150 E 200 N STE A, LOGAN, UT 84321-4036
(435) 753-2828
(435) 753-3628

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
260457
UT

Other

Enumeration date
02/05/2019
Last updated
02/05/2019
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