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Organization
NORTH BEELINE DENTAL LLC
Active
Organization
NORTH BEELINE DENTAL LLC
Active
Other names
Anderson Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (CREDENTIALING DIRECTOR)
(972) 869-3789
Entity
Organization
Contact information
Practice address
712 N BEELINE HWY, PAYSON, AZ 85541-3706
(928) 474-4581
Mailing address
712 N BEELINE HWY, PAYSON, AZ 85541-3706
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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