Individual
CARLA L. CHAVEZ-MAYORGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1222 JEFFERSON PARK AVE, CHARLOTTESVILLE, VA 22903-3410
(434) 924-1774
(434) 243-6378
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411881
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2014
Last updated
10/13/2020
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