| NPI | 1215107149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DAVID CASTO Owner 801-870-0625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 141441) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2024-03-26 |