Provider Demographics
NPI:1316041825
Name:GAILEY, DAVID C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:GAILEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:D.
Other - Middle Name:CRAIG
Other - Last Name:GAILEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1662 W 9000 S
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-9233
Mailing Address - Country:US
Mailing Address - Phone:801-566-7269
Mailing Address - Fax:
Practice Address - Street 1:1662 W 9000 S
Practice Address - Street 2:SUITE B
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9233
Practice Address - Country:US
Practice Address - Phone:801-566-7269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT140316-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice