| NPI | 1023186111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND SCOTT HLAVATY President Owner 435-753-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: UT 932604579921) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2008-07-30 |