Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 35757 | CA |
NPI | 1124039102 |
---|---|
Provider Name | Dr. Steven Mayhew Mansfield |
First Address | Napa, CA 94559-2519 |
Second Address | Napa, CA 94559-2519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |