Michael L. Gailey, DDS

Individual provider Active NPI General Practice Dentistry · Syracuse, UT

NPI 1194755652 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1194755652
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
141253-9922 (UT)
Practice address
1747 Heritage LN
Suite B201
Syracuse, UT 84075-8552
Phone
(801) 776-2461
Fax
(801) 776-2469
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
141253-9922UTMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 141253-9922 UT Yes

Addresses

Primary practice location

1747 Heritage LN
Suite B201
Syracuse, UT 84075-8552

Mailing address

1747 Heritage LN
Suite B201
Syracuse, UT 84075-8552
Phone (801) 776-2461

Other providers in Syracuse, UT

All providers in Syracuse, UT · General Practice Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.