NPI | 1154892677 |
---|---|
Doing Business As | PINE DENTISTRY |
Entity Type | Organization |
Authorized Contact | DALE MAYFIELD President 770-916-5036 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223E0200X Dentist, Endodontics |
1223P0106X Dentist, Oral and Maxillofacial Pathology | |
1223P0221X Dentist, Pediatric Dentistry | |
1223P0300X Dentist, Periodontics | |
Enumeration Date | 2018-12-10 |
Last Update Date | 2018-12-10 |