| Genesis Dental Of South Jordan | |
|
11531 S District Dr Ste 600 South Jordan UT 84095-5782 | |
| (801) 254-7272 | |
| (801) 254-6565 |
| Full Name | Genesis Dental Of South Jordan |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11531 S District Dr Ste 600, South Jordan, Utah |
| Authorized Official Name and Position | Jason David Casto (MEMBER/OWNER) |
| Authorized Official Contact | 8018700625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Dental Of South Jordan 12180 S 300 E Unit 270 Draper UT 84020-2612 Ph: (801) 870-0625 | Genesis Dental Of South Jordan 11531 S District Dr Ste 600 South Jordan UT 84095-5782 Ph: (801) 254-7272 |
| NPI Number | 1427452614 |
|---|---|
| Provider Enumeration Date | 10/16/2014 |
| Last Update Date | 03/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427452614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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