Provider Demographics
NPI:1821766049
Name:BESTIE LIFE, LLC
Entity Type:Organization
Organization Name:BESTIE LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GENA
Authorized Official - Middle Name:FRIES
Authorized Official - Last Name:SCHULTHEIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-905-8738
Mailing Address - Street 1:2331 FOREST DR STE E
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3868
Mailing Address - Country:US
Mailing Address - Phone:410-224-4500
Mailing Address - Fax:
Practice Address - Street 1:2331 FOREST DR STE E
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3868
Practice Address - Country:US
Practice Address - Phone:410-224-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental