Provider Demographics
NPI:1932071784
Name:HAILE PLANTATION FAMILY DENTAL CENTER
Entity type:Organization
Organization Name:HAILE PLANTATION FAMILY DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:352-375-6116
Mailing Address - Street 1:5347 SW 91ST TER STE B
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-7125
Mailing Address - Country:US
Mailing Address - Phone:352-375-6116
Mailing Address - Fax:352-378-2184
Practice Address - Street 1:5347 SW 91ST TER STE B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-7125
Practice Address - Country:US
Practice Address - Phone:352-375-6116
Practice Address - Fax:352-378-2184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty