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General NPI Number Information
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NPI Number | 1932071784
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Entity Type | Organization
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Legal Business Name | HAILE PLANTATION FAMILY DENTAL CENTER
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 5347 SW 91ST TER STE B
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City | GAINESVILLE
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State | FL
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Zip | 32608-7125
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Country | US
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Telephone | 352-375-6116
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Fax | 352-378-2184
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Provider Business Mailing Address
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Address Line | 5347 SW 91ST TER STE B
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City | GAINESVILLE
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State | FL
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Zip | 32608-7125
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Country | US
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Telephone | 352-375-6116
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Fax | 352-378-2184
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Authorized Official
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Title or Position | OWNER
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Name | GARY BANFIELD
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Credential | DDS
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Telephone | 352-375-6116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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