Provider Demographics
NPI:1043478217
Name:BAILEY, ASHLEY G (DDS)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:G
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SECRETARIAT WAY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-5038
Mailing Address - Country:US
Mailing Address - Phone:414-477-5877
Mailing Address - Fax:
Practice Address - Street 1:1526 UTE BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-7522
Practice Address - Country:US
Practice Address - Phone:435-615-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7007902-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist