# THE GOOD DENTIST LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306310867
- **Authorized official:** MIRANDA JONES (MANAGER)
- **Authorized official phone:** (623) 302-0220

## Contact information

- **Practice address:** 821 W WICKENBURG WAY, WICKENBURG, AZ 85390-4263
- **Practice address phone:** (928) 684-1000
- **Mailing address:** 821 W WICKENBURG WAY, WICKENBURG, AZ 85390-4263
- **Mailing address phone:** (623) 302-0220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/17/2019
- **Last updated:** 04/19/2023