Genesis Dental Of Taylorsville
Dentist, General Practice in Taylorsville, UT. Organization (NPI-2).
NPI number1609986140
StatusActive
Last updated in NPPESMar 26, 2024
Details
- NPI
- 1609986140
- Entity type
- Organization (NPI-2)
- Legal business name
- Genesis Dental Of Taylorsville
- Organization subpart
- No
- Enumeration date
- Aug 30, 2006
- Certification date
- Mar 26, 2024
- Last updated
- Mar 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
6087 S Redwood RdSuite A
Taylorsville, UT 84123-5330
Phone 801-969-7282 · Fax 801-957-0411
Mailing address
12180 S 300 E Unit 270Draper, UT 84020-2612
Phone 801-870-0625
Authorized official
Jason D Casto
Owner/Member
8018700625
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