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1437347457
SHAHRAM FAZILAT
VANCOUVER, WA
NPI
1437347457
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: WA DE00010790)
Enumeration Date
2007-10-04
Last Update Date
2007-10-04
Business Address
Dr. SHAHRAM FAZILAT D.D.S.
1307 NE 78TH ST SUITE B13
VANCOUVER, WA 98665-9670
Phone number: 360-574-0900
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Mailing Address
Dr. SHAHRAM FAZILAT D.D.S.
930 NW 12TH AVE APT#519
PORTLAND, OR 97209-3072
Phone number:
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