Organization
KOOL SMILES OK, PC
Active
Other names
Jubilee Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE G MAYFIELD DDS (PRESIDENT)
(770) 916-5036
Entity
Organization
Contact information
Practice address
1200 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-4866
(800) 920-9947
Mailing address
1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
(770) 916-5028
(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
03/29/2010
Last updated
12/19/2018
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