Provider Demographics
NPI:1326146424
Name:MAYFIELD, CHRISTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIN
Middle Name:
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTIN
Other - Middle Name:
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:110 EAST COOPER AVE.
Mailing Address - Street 2:PO BOX 1922
Mailing Address - City:FOLLY BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29439-1922
Mailing Address - Country:US
Mailing Address - Phone:843-588-2207
Mailing Address - Fax:
Practice Address - Street 1:109 BEE ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-5703
Practice Address - Country:US
Practice Address - Phone:843-789-7351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC39251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice