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Organization
W. MAIN STREET DENTAL LEWISVILLE, TX, P.C.
Active
Organization
W. MAIN STREET DENTAL LEWISVILLE, TX, P.C.
Active
Other names
Jubilee Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE MAYFIELD DMD (PRESIDENT)
(770) 916-5036
Entity
Organization
Contact information
Practice address
724 W MAIN ST STE 316, LEWISVILLE, TX 75067
(469) 312-6201
(469) 312-6202
Mailing address
1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
(770) 916-5036
(678) 285-4760
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
05/16/2018
Last updated
05/23/2018
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