Individual
KYLE ROBERT MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 E CALUMET ST, APPLETON, WI 54915-4743
(920) 731-1550
(920) 731-4403
Mailing address
W6589 FIRELANE 7, MENASHA, WI 54952-9418
(920) 750-8278
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001797-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2025
Last updated
05/28/2025
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