| Genesis Orthodontics, Llc | |
|
3725 W 4100 S Ste 240 West Valley City UT 84120-5530 | |
| (801) 969-9070 | |
| Not Available |
| Full Name | Genesis Orthodontics, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3725 W 4100 S Ste 240, 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 Orthodontics, Llc 12180 S 300 E Unit 270 Draper UT 84020-2612 Ph: (801) 969-9070 | Genesis Orthodontics, Llc 3725 W 4100 S Ste 240 West Valley City UT 84120-5530 Ph: (801) 969-9070 |
| NPI Number | 1609372903 |
|---|---|
| Provider Enumeration Date | 04/04/2018 |
| Last Update Date | 03/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609372903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 144139 (Utah) | Primary |
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