| NPI | 1689877557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE GARY MAYFIELD Dentist 678-904-5665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN011874) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-08-22 |