MAYRA BAZAVILVAZO

COSTA MESA, CA
NPI1437440260
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1223P0300X Dentist, Periodontics
(Licence: CA  60257)
Additional Taxonomies1223P0300X Dentist, Periodontics
(Licence: FL  DN17300)
Enumeration Date2011-04-27
Last Update Date2016-06-10
Business Address
-- MAYRA BAZAVILVAZO D.M.D
1012 BRIOSO DR STE 105
COSTA MESA, CA 92627-4544
Phone number: 305-298-8797
Mailing Address
-- MAYRA BAZAVILVAZO D.M.D
1401 AVOCADO AVE 502
NEWPORT BEACH, CA 92660-7720
Phone number: 949-640-9554