| NPI | 1902094600 |
|---|---|
| Doing Business As | ELSTAR DENTAL |
| Doing Business As | KOOL SMILES |
| 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 | 2007-10-09 |
| Last Update Date | 2018-09-17 |