Provider Demographics
NPI:1225356496
Name:DEFAY, DAVID KAY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KAY
Last Name:DEFAY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:95 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-1922
Mailing Address - Country:US
Mailing Address - Phone:801-546-0892
Mailing Address - Fax:801-546-2066
Practice Address - Street 1:95 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-1922
Practice Address - Country:US
Practice Address - Phone:801-546-0892
Practice Address - Fax:801-546-2066
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT7764854-99221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics