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Individual

DR. ANTHONY W MAYFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1313 LUISA ST STE A, SANTA FE, NM 87505-4157
(505) 983-8051
Mailing address
1313 LUISA ST STE A, SANTA FE, NM 87505-4157
(505) 983-8051

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NM1582
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NM1582
DENTAL LICENSE
NM
Enumeration date
07/31/2006
Last updated
07/08/2007
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