Provider Demographics
NPI:1881821908
Name:MAYFIELD, WILL PERRY (DDS)
Entity Type:Individual
Prefix:
First Name:WILL
Middle Name:PERRY
Last Name:MAYFIELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:TX
Mailing Address - Zip Code:75758-0417
Mailing Address - Country:US
Mailing Address - Phone:903-849-3480
Mailing Address - Fax:903-849-2750
Practice Address - Street 1:216 JONES
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:TX
Practice Address - Zip Code:75758-2283
Practice Address - Country:US
Practice Address - Phone:903-849-3480
Practice Address - Fax:903-849-2750
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX245851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice