| Sunnybrook Dentistry | |
|
989 Ellis Ave Jackson MS 39209-6256 | |
| (678) 904-5665 | |
| (678) 904-5666 |
| Full Name | Sunnybrook Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 989 Ellis Ave, Jackson, Mississippi |
| Authorized Official Name and Position | Dale G Mayfield (OWNER) |
| Authorized Official Contact | 7709165036 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunnybrook Dentistry 210 Interstate North Pkwy Se Ste 300 Atlanta GA 30339-2233 Ph: (770) 916-5028 | Sunnybrook Dentistry 989 Ellis Ave Jackson MS 39209-6256 Ph: (678) 904-5665 |
| NPI Number | 1689864662 |
|---|---|
| Provider Enumeration Date | 07/26/2007 |
| Last Update Date | 04/27/2026 |
| Certification Date | 04/27/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689864662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (NU) | Secondary |
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (NU) | Secondary |
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