GENESIS DENTAL OF PROVO

PROVO, UT
NPI1629581871
Entity TypeOrganization
Authorized ContactJASON D CASTO
Owner/Member
801-870-0625
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2017-11-09
Last Update Date2017-11-09
Business Address
GENESIS DENTAL OF PROVO
2255 N UNIVERSITY PKWY STE 39
PROVO, UT 84604-1503
Phone number: 801-319-6743
Mailing Address
GENESIS DENTAL OF PROVO
2255 N UNIVERSITY PKWY STE 39
PROVO, UT 84604-1503
Phone number: 801-319-6743
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