| NPI | 1760712335 |
|---|---|
| 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 | 2010-01-05 |
| Last Update Date | 2019-06-17 |