Bazavilvazo, Mayra
Bazavilvazo, Mayra is an sole proprietor health care provider with primary practice located at 1012 Brioso Dr Ste 105 , Costa Mesa CA 92627-4544. She recently has only one registered license in Dental Providers / Periodontics, which is considered as her primary health care specialty. Bazavilvazo, Mayra can be contacted via phone (305) 298-8797.Contact Information
Primary practice address
1012 Brioso Dr Ste 105
Costa Mesa CA 92627-4544
Phone: (305) 298-8797
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 60257 | California |
| Dental Providers / Periodontics | 1223P0300X | DN17300 | Florida |
Profile Details
| NPI number | 1437440260 |
|---|---|
| LBN Legal business name | Bazavilvazo, Mayra |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 27th, 2011 |
| Last updated | Jun 10th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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