Individual
DEVERICK M MAYFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3750 S LINDBERGH BLVD STE 102, SAINT LOUIS, MO 63127-1375
(217) 821-0445
Mailing address
710 S PARK ST, EFFINGHAM, IL 62401-2646
(217) 821-0445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2021025918
MO
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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