NPI | 1598080095 |
---|---|
Entity Type | Organization |
Authorized Contact | DALE GARY MAYFIELD President 770-916-5036 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice |
Additional Taxonomies | 1223E0200X Dentist Endodontics |
1223S0112X Dentist Oral and Maxillofacial Surgery | |
Enumeration Date | 2010-03-29 |
Last Update Date | 2018-09-17 |