| Genesis Dental Of Salt Lake, Llc | |
|
420 E South Temple Ste 220 Salt Lake City UT 84111-1329 | |
| (801) 355-3286 | |
| (801) 355-1320 |
| Full Name | Genesis Dental Of Salt Lake, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 420 E South Temple Ste 220, Salt Lake City, Utah |
| Authorized Official Name and Position | Jason D Casto (OWNER/MEMBER) |
| Authorized Official Contact | 8018700625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Dental Of Salt Lake, Llc 12180 S 300 E Unit 270 Draper UT 84020-2612 Ph: (801) 870-0625 | Genesis Dental Of Salt Lake, Llc 420 E South Temple Ste 220 Salt Lake City UT 84111-1329 Ph: (801) 355-3286 |
| NPI Number | 1710095781 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 03/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710095781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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