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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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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