Organization
AZUL FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLA LUCIA CHAVEZ-MAYORGA DDS (DENTIST/OWNER)
(305) 510-0828
Entity
Organization
Contact information
Practice address
9605 CRITZERS SHOP RD, AFTON, VA 22920-2416
(540) 456-6571
(540) 456-6535
Mailing address
1305 PENFIELD LN, CHARLOTTESVILLE, VA 22901-3769
(305) 510-0828
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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