Organization
GENESIS DENTAL OF SOUTH JORDAN
Active
Other names
Genesis Dental at The District, Genesis Dental of Riverton
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON DAVID CASTO (MEMBER/OWNER)
(801) 870-0625
Entity
Organization
Contact information
Practice address
11531 S DISTRICT DR STE 600, SOUTH JORDAN, UT 84095-5782
(801) 254-7272
(801) 254-6565
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
—
—
Other
Enumeration date
10/16/2014
Last updated
03/26/2024
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