# SMALL SMILES DENTAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134662752
- **Authorized official:** MR. JASON D CASTO (MEMBER)
- **Authorized official phone:** (801) 870-0625

## Contact information

- **Practice address:** 6087 S REDWOOD RD STE C, TAYLORSVILLE, UT 84123-6854
- **Practice address phone:** (801) 870-0625
- **Practice address fax:** (801) 285-9170
- **Mailing address:** 6087 S REDWOOD RD STE C, TAYLORSVILLE, UT 84123-6854
- **Mailing address phone:** (801) 870-0625
- **Mailing address fax:** (801) 285-9170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 11/30/2016
- **Last updated:** 11/30/2016