Individual
DR. RAVEN ELAINE YAYAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4905 STONE FALLS CTR UNIT A, O FALLON, IL 62269-7802
(618) 622-3377
Mailing address
4201 W PINE BLVD APT 103, SAINT LOUIS, MO 63108-3078
(901) 849-9389
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2021044569
MO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019.034684
IL
Other
Enumeration date
11/03/2021
Last updated
07/16/2024
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