NPI | 1881280410 |
---|---|
Entity Type | Organization |
Authorized Contact | DALE MAYFIELD President 770-916-5036 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 1223E0200X Dentist, Endodontics |
1223P0221X Dentist, Pediatric Dentistry | |
1223P0300X Dentist, Periodontics | |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
Enumeration Date | 2020-12-17 |
Last Update Date | 2020-12-17 |