Provider Demographics
NPI:1851359897
Name:SCOVILLE, RONALD JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JAMES
Last Name:SCOVILLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1063 W 4000 N
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:UT
Mailing Address - Zip Code:84414-3328
Mailing Address - Country:US
Mailing Address - Phone:801-528-8915
Mailing Address - Fax:801-776-8428
Practice Address - Street 1:466 N MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-3222
Practice Address - Country:US
Practice Address - Phone:801-776-6441
Practice Address - Fax:801-776-8428
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT59182541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice