Genesis Dental of Provo
Genesis Dental of Provo is a Dental Clinic/Center in Provo, Utah. Registered with an NPI since 2017.
- In the registry since
- 2017
Practice location Address checks out
2255 N University Pkwy Ste 39Provo, UT 84604-1503
Phone: (801) 319-6743
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dental Clinic/Center (primary) | Taxonomy 261QD0000X |
|---|
Record details
| NPI number | 1629581871 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jason Casto — Owner/Member · (801) 870-0625 |
| NPI enumerated | November 9, 2017 |
| Last updated in NPPES | November 9, 2017 |
| Mailing address | 2255 N University Pkwy Ste 39, Provo, UT 84604-1503 |
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