Organization
SMALL SMILES DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON D CASTO (MEMBER)
(801) 870-0625
Entity
Organization
Contact information
Practice address
6087 S REDWOOD RD STE C, TAYLORSVILLE, UT 84123-6854
(801) 870-0625
(801) 285-9170
Mailing address
6087 S REDWOOD RD STE C, TAYLORSVILLE, UT 84123-6854
(801) 870-0625
(801) 285-9170
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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