Organization
HATTIESBURG ROAD DENTAL, P.C.
Active
Other names
KOOL SMILES, Sunnybrook Dentistry & Braces, Sunnybrook 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
4463 N STATE ST, JACKSON, MS 39206-5306
(800) 920-9947
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
08/28/2009
Last updated
04/27/2026
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