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401 S Gloster St Suite 101 Tupelo MS 38801-5539 | |
| (770) 916-9000 | |
| (678) 904-5666 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 401 S Gloster St, Tupelo, Mississippi |
| 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 |
|---|---|
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 Ph: (770) 916-5028 | 401 S Gloster St Suite 101 Tupelo MS 38801-5539 Ph: (770) 916-9000 |
| NPI Number | 1528258464 |
|---|---|
| Provider Enumeration Date | 07/26/2007 |
| Last Update Date | 01/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528258464 | NPI | - | NPPES |
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