person
Dr. Shahram Fazilat, DDS
Pediatric Dentist in Vancouver, Washington
NPI 1437347457

Shahram Fazilat is a Pediatric Dentist based in Portland, WA and is specialized in Pediatric Dentistry. Shahram Fazilat practices in Vancouver, WA and has the professional credentials of DDS. The NPI Number for Shahram Fazilat is 1437347457 and holds a License No. DE00010790 (Washington).

The current practice location address for Shahram Fazilat is 1307 Ne 78Th St, Vancouver, WA and can be reached out via phone at 360-574-0900 and via fax at 360-574-6338.

Location: 1307 Ne 78Th St, Vancouver, WA, 97209-3072
person
Provider Profile Details
NPI Number
1437347457
Provider Name
Shahram Fazilat
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1307 Ne 78Th St, Vancouver, WA, 97209-3072
Phone Number
360-574-0900
Fax Number
360-574-6338
Provider Enumeration Date
10/04/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1307 Ne 78Th St
City
State
Zip
98665-9670
Phone Number
360-574-0900
Fax Number
360-574-6338
person
Provider Business Mailing Address Details
Address
1307 Ne 78Th St
City
State
Zip
98665-9670
Phone Number
360-574-0900
Fax Number
360-574-6338
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
DE00010790 (Washington)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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