# MAYFIELD DMD, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kool Smiles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063661338
- **Authorized official:** DR. DALE G MAYFIELD DMD (PRESIDENT)
- **Authorized official phone:** (770) 916-5028

## Contact information

- **Practice address:** 8104 EVERGREEN WAY, SUITE B, MAILBOX 3, EVERETT, WA 98203-6419
- **Practice address phone:** (425) 374-0894
- **Practice address fax:** (770) 904-5666
- **Mailing address:** 1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
- **Mailing address phone:** (770) 916-5028
- **Mailing address fax:** (678) 247-7858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 09/11/2008
- **Last updated:** 03/04/2011