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Organization
HIGHWAY 351 PC
Active
Organization
HIGHWAY 351 PC
Active
Other names
Resolution Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DALE MAYFIELD DMD (PRESIDENT)
(770) 916-5028
Entity
Organization
Contact information
Practice address
3150 S 31ST ST, TEMPLE, TX 76502-1803
(800) 920-9947
Mailing address
1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
09/20/2011
Last updated
01/29/2015
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