NPI | 1588947212 |
---|---|
Doing Business As | BUENA VISTA DENTAL |
Entity Type | Organization |
Authorized Contact | DALE MAYFIELD President 770-916-5028 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223E0200X Dentist, Endodontics |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
Enumeration Date | 2011-09-20 |
Last Update Date | 2014-12-19 |