Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 3864 Hwy 64 W, Tyler, Texas |
Authorized Official Name and Position | Dale Mayfieldf (PRESIDENT) |
Authorized Official Contact | 7709165028 |
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: () - | 3864 Hwy 64 W Tyler TX 75704-6924 Ph: (770) 916-9000 |
NPI Number | 1366794760 |
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Provider Enumeration Date | 10/09/2012 |
Last Update Date | 01/29/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366794760 | NPI | - | NPPES |
Kim Fretty Orthodontics Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6989 Highlands Ln, Tyler, TX 75703 Phone: 903-561-7873 | |
Pediatric Dentistry Of Tyler, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3607 Old Jacksonville Rd, Tyler, TX 75701 Phone: 903-595-5476 | |