Organization
GOOD LIFE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN BLANE JACKSON DDS (OWNER/DENTIST)
(858) 705-5958
Entity
Organization
Contact information
Practice address
20061 E RITTENHOUSE RD, QUEEN CREEK, AZ 85142-9715
(435) 637-2100
Mailing address
250 N FAIRGROUNDS RD STE 1, PRICE, UT 84501-4201
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265624332
NPPES
—
Enumeration date
01/03/2023
Last updated
04/07/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us