Organization
EAST WASHINGTON STREET DENTAL INDY, IN, PC
Active
Other names
Pippin Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE MAYFIELD DMD (PRESIDENT)
(770) 916-5036
Entity
Organization
Contact information
Practice address
9972 E WASHINGTON ST, INDIANAPOLIS, IN 46229-3040
(770) 916-5036
Mailing address
1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
(770) 916-5036
(678) 285-4760
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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