Provider Demographics
NPI:1184621195
Name:HVAL, SCOTT R (DMD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:HVAL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6736 SE POWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-2637
Mailing Address - Country:US
Mailing Address - Phone:503-771-3828
Mailing Address - Fax:503-771-6471
Practice Address - Street 1:9002 NW WOOD ROSE LOOP
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-4189
Practice Address - Country:US
Practice Address - Phone:503-291-1368
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR64181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice