Highway 351 PC

NPI #1366794760 in Tyler, Texas

Provider Information

NPI Number: 1366794760
Entity Type: Organization
Organization Name: Highway 351 PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 9, 2012
Last Updated: Jan 29, 2015

Practice Location

Address: 3864 HWY 64 W
City: Tyler
State: Texas
ZIP Code: 75704-6924
Phone: (770) 916-9000

Authorized Official

Name: DR. DALE MAYFIELDF
Title: PRESIDENT
Phone: (770) 916-5028

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Dentist - General Practice — General Practice	1223G0001X	Primary

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