SHAHRAM FAZILAT

VANCOUVER, WA
NPI1437347457
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: WA  DE00010790)
Enumeration Date2007-10-04
Last Update Date2007-10-04
Business Address
Dr. SHAHRAM FAZILAT D.D.S.
1307 NE 78TH ST SUITE B13
VANCOUVER, WA 98665-9670
Phone number: 360-574-0900
Mailing Address
Dr. SHAHRAM FAZILAT D.D.S.
930 NW 12TH AVE APT#519
PORTLAND, OR 97209-3072
Phone number: