Organization
GENESIS DENTAL OF ROY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON D CASTO (OWNER/MEMBER)
(801) 838-8030
Entity
Organization
Contact information
Practice address
4896 S 1900 W, SUITE C, ROY, UT 84067-2994
(801) 825-3898
(801) 825-5982
Mailing address
6087 S REDWOOD RD, SUITE C, TAYLORSVILLE, UT 84123-5330
(801) 838-8030
(801) 352-1872
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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