Good Life Dental

LBN: Good Life Dental
Good Life Dental is an health care organization with primary practice located at 20061 E Rittenhouse Rd , Queen Creek AZ 85142-9715. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Good Life Dental can be contacted via phone (435) 637-2100, or through Jackson, Marvin Blane via phone (435) 637-2100.

Contact Information

Primary practice address
20061 E Rittenhouse Rd Queen Creek AZ 85142-9715
Phone: (435) 637-2100
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Marvin Blane Doctor of Dental Surgery (DDS)
Phone: (435) 637-2100

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1104539303
LBN Legal business name Good Life Dental
DBA Doing business as
Authorized official Jackson, Marvin Blane Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 3rd, 2023
Last updated Jan 3rd, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104539303 NPPES
Other 1265624332 NPPES

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