# NORTH BEELINE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Anderson Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982373064
- **Authorized official:** FAITH GASKINS (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 712 N BEELINE HWY, PAYSON, AZ 85541-3706
- **Practice address phone:** (928) 474-4581
- **Mailing address:** 712 N BEELINE HWY, PAYSON, AZ 85541-3706
- **Mailing address phone:** (928) 474-4581

## Taxonomy

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

## Other

- **Enumeration date:** 09/10/2021
- **Last updated:** 09/10/2021