Healthcare Provider Details

I. General information

NPI: 1790794550
Provider Name (Legal Business Name): SCOTT HINCKLEY CRAVEN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2685 N 1000 W
PLEASANT VIEW UT
84414-2660
US

IV. Provider business mailing address

1319 W 3775 N
PLEASANT VIEW UT
84414-3311
US

V. Phone/Fax

Practice location:
  • Phone: 801-333-3456
  • Fax: 801-528-4266
Mailing address:
  • Phone: 801-333-3456
  • Fax: 801-528-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number323051-6009
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number323051-9922
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: