Individual
DR. ANGEL FERNANDO MOGROVEJO FAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
461 MCLAWS CIR STE 1, WILLIAMSBURG, VA 23185-6350
(757) 221-0249
Mailing address
461 MCLAWS CIR STE 1, WILLIAMSBURG, VA 23185-6350
(757) 221-0249
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401415449
VA
Other
Enumeration date
04/10/2013
Last updated
03/11/2019
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