Provider Demographics
NPI:1043422603
Name:LLOYD, WAYNE ASHTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:ASHTON
Last Name:LLOYD
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 1:3521 MARKET ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-3619
Mailing Address - Country:US
Mailing Address - Phone:801-957-1850
Mailing Address - Fax:801-969-2008
Practice Address - Street 1:3521 MARKET ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-3619
Practice Address - Country:US
Practice Address - Phone:801-957-1850
Practice Address - Fax:801-969-2008
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1294249922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist