NPI | 1154892677 |
---|---|
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 |