NPI | 1700078029 |
---|---|
Doing Business As | SUNNYBROOK DENTISTRY |
Entity Type | Organization |
Authorized Contact | DALE MAYFIELD President 770-916-5036 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
1223E0200X Dentist, Endodontics | |
Enumeration Date | 2007-08-10 |
Last Update Date | 2019-01-04 |