| Genesis Dental Of Granger | |
|
3725 W 4100 S Suite 240 West Valley City UT 84120-5530 | |
| (801) 965-2700 | |
| (801) 965-2701 |
| Full Name | Genesis Dental Of Granger |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3725 W 4100 S, West Valley City, Utah |
| Authorized Official Name and Position | Jason D 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 Granger 12180 S 300 E Unit 270 Draper UT 84020-2612 Ph: (801) 870-0625 | Genesis Dental Of Granger 3725 W 4100 S Suite 240 West Valley City UT 84120-5530 Ph: (801) 965-2700 |
| NPI Number | 1548685266 |
|---|---|
| Provider Enumeration Date | 03/04/2014 |
| Last Update Date | 03/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548685266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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