MEDICARE: DR. SCOTT HINCKLEY CRAVEN D.D.S.

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	101YP2500X	Professional Counselor	323051-6009	UT
2	1223G0001X	General Practice Dentistry	323051-9922	UT

General Provider Information

NPI Number	:	1790794550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT HINCKLEY CRAVEN D.D.S.

Provider Business Mailing Address
First Line	:	1319 W 3775 N
Second Line	:
City	:	PLEASANT VIEW
State	:	UT
Zip	:	84414-3311
Country	:	US
Telephone Number	:	801-333-3456
Fax Number	:	801-528-4266

Provider Business Practice Location Address
First Line	:	2685 N 1000 W
Second Line	:
City	:	PLEASANT VIEW
State	:	UT
Zip	:	84414-2660
Country	:	US
Telephone Number	:	801-333-3456
Fax Number	:	801-528-4266

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	02/02/2022

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