Provider Demographics
NPI:1851497366
Name:ASAY, GAYLEN S (DDS)
Entity Type:Individual
Prefix:
First Name:GAYLEN
Middle Name:S
Last Name:ASAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:GAYLEN
Other - Middle Name:S
Other - Last Name:ASAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1459 N MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6092
Mailing Address - Country:US
Mailing Address - Phone:801-292-4440
Mailing Address - Fax:801-292-5665
Practice Address - Street 1:1459 N MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-6092
Practice Address - Country:US
Practice Address - Phone:801-292-4440
Practice Address - Fax:801-292-5665
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1420981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice