Organization
GENESIS DENTAL OF TAYLORSVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON D CASTO (OWNER/MEMBER)
(801) 870-0625
Entity
Organization
Contact information
Practice address
6087 S REDWOOD RD, SUITE A, TAYLORSVILLE, UT 84123-5330
(801) 969-7282
(801) 957-0411
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
08/30/2006
Last updated
03/26/2024
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