Organization
BESTLIFE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA LYNN WILSON DMD, MPH (CO-OWNER)
(602) 369-3281
Entity
Organization
Contact information
Practice address
20061 E RITTENHOUSE RD, QUEEN CREEK, AZ 85142-9715
(602) 499-4499
Mailing address
PO BOX 9, HIGLEY, AZ 85236-0009
(602) 369-3281
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134431729
—
ND
Enumeration date
11/15/2019
Last updated
11/15/2019
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