NPI | 1427452614 |
---|---|
Doing Business As | GENESIS DENTAL AT THE DISTRICT |
Former Legal Business Name | GENESIS DENTAL OF RIVERTON |
Entity Type | Organization |
Authorized Contact | JASON DAVID CASTO Member/Owner 801-870-0625 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2014-10-16 |
Last Update Date | 2024-03-26 |