Organization
NORTH CARRIAGE DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE MAYFIELD (PRESIDENT)
(770) 916-5036
Entity
Organization
Contact information
Practice address
650 N CARRIAGE PKWY STE 60, WICHITA, KS 67208-4512
(316) 686-2721
(316) 686-2744
Mailing address
1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
(770) 916-5036
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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