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Organization
NORTH MESA DENTAL, PC
Active
Organization
NORTH MESA DENTAL, PC
Active
Other names
Goodland Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE G MAYFIELD DMD (PRESIDENT)
(770) 916-5036
Entity
Organization
Contact information
Practice address
2539 JUDSON RD, LONGVIEW, TX 75605-4643
(678) 904-5665
Mailing address
210 INTERSTATE NORTH PKWY SE STE 300, ATLANTA, GA 30339-2233
(770) 916-9000
(678) 247-7858
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
10/09/2007
Last updated
02/03/2022
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