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Individual

DR. DALE GARY MAYFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
4324 COVINGTON HWY, DECATUR, GA 30035-1208
(404) 289-6454
Mailing address
1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
(770) 716-1725

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN011874
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000907255A
GA
Enumeration date
09/04/2006
Last updated
03/19/2018
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