Organization
GENESIS DENTAL OF ST. GEORGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON D CASTO (MANAGER/OWNER)
(801) 870-0625
Entity
Organization
Contact information
Practice address
1449 N 1400 W, SUITE A1, ST GEORGE, UT 84770-5960
(435) 656-2800
Mailing address
6087 S REDWOOD RD STE C, TAYLORSVILLE, UT 84123-6854
(801) 870-0625
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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