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1926 E Southeast Loop 323 Tyler TX 75701-8337 | |
(678) 904-5665 | |
(678) 904-5666 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1926 E Southeast Loop 323, Tyler, Texas |
Authorized Official Name and Position | Dale G Mayfield (PRESIDENT) |
Authorized Official Contact | 7709165036 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 Ph: (770) 916-5028 | 1926 E Southeast Loop 323 Tyler TX 75701-8337 Ph: (678) 904-5665 |
NPI Number | 1356533103 |
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Provider Enumeration Date | 08/15/2007 |
Last Update Date | 06/17/2019 |
Identifier | Type | State | Issuer |
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1356533103 | NPI | - | NPPES |
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