Good Life Dental
NPI #1104539303 in Queen Creek, Arizona
Provider Information
- NPI Number
- 1104539303
- Entity Type
- Organization
- Organization Name
- Good Life Dental
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jan 3, 2023
- Last Updated
- Jan 3, 2023
Practice Location
- Address
- 20061 E RITTENHOUSE RD
- City
- Queen Creek
- State
- Arizona
- ZIP Code
- 85142-9715
- Phone
- (435) 637-2100
Authorized Official
- Name
- MARVIN BLANE JACKSON, DDS
- Title
- OWNER/DENTIST
- Phone
- (435) 637-2100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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