North Beeline Dental LLC

NPI #1205503299 in Payson, Arizona

Provider Information

NPI Number: 1205503299
Entity Type: Organization
Organization Name: North Beeline Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 26, 2021
Last Updated: Aug 26, 2021

Practice Location

Address: 712 N BEELINE HWY
City: Payson
State: Arizona
ZIP Code: 85541-3706
Phone: (928) 474-4581

Authorized Official

Name: FAITH GASKINS
Title: CREDENTIALING DIRECTOR
Phone: (972) 869-3789

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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