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Organization
RIVERS EDGE DENTAL, P.C.
Active
Organization
RIVERS EDGE DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE MAYFIELD DMD (PRESIDENT)
(770) 916-5036
Entity
Organization
Contact information
Practice address
3403 RIVERS EDGE TRL, KINGWOOD, TX 77339-2634
(281) 361-0102
Mailing address
1090 NORTHCHASE PKWY SE STE 190, MARIETTA, GA 30067-6405
(770) 916-9000
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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