Organization
GENESIS DENTAL THANKSGIVING POINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON D CASTO (MEMBER/OWNER)
(801) 870-0625
Entity
Organization
Contact information
Practice address
3098 W EXECUTIVE PKWY STE 250, LEHI, UT 84043-4715
(801) 766-5300
Mailing address
12180 S 300 E UNIT 270, DRAPER, UT 84020-2612
(801) 870-0625
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
03/26/2024
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