MEDICARE: DR. SCOTT R HVAL DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6418	OR

General Provider Information

NPI Number	:	1184621195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT R HVAL DMD

Provider Business Mailing Address
First Line	:	6736 SE POWELL BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-2637
Country	:	US
Telephone Number	:	503-771-3828
Fax Number	:	503-771-6471

Provider Business Practice Location Address
First Line	:	9002 NW WOOD ROSE LOOP
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-4189
Country	:	US
Telephone Number	:	503-291-1368
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/08/2007

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