Organization
GENESIS DENTAL OF OREM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON DAVID CASTO (OWNER)
(801) 870-0625
Entity
Organization
Contact information
Practice address
320 E 800 S, OREM, UT 84097-6386
(801) 224-9555
(801) 352-1872
Mailing address
12180 S 300 E UNIT 270, DRAPER, UT 84020-2612
(801) 870-0625
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
141441
UT
Other
Enumeration date
03/06/2008
Last updated
03/26/2024
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