Raven Elaine Yayah, DDS Valid NPI

Individual provider · Orthodontics and Dentofacial Orthopedics Dentistry · O Fallon, IL

NPI

1174288153

Type

Individual (Type 1)

Primary specialty

Orthodontics and Dentofacial Orthopedics Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223X0400X

License number

019.034684 (IL)

Sex

Female

Sole proprietor

Yes

Enumerated

2021-11-03

Last updated

2024-07-16