Individual provider · Type 1 NPI

Shahram Fazilat, DDS

Pediatric Dentistry · Vancouver, WA

NPI number 1437347457 Active

Practice location

1307 NE 78th St, Suite B13
Vancouver, WA 98665-9670

Call (360) 574-0900 Map

Fax (360) 574-6338

Mailing address

930 NW 12th Ave, APT#519
Portland, OR 97209-3072

Specialties and licenses

TaxonomyCodeLicense
Pediatric Dentistry Primary 1223P0221XDE00010790 (WA)

Pediatric Dentistry: 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.

3 other providers at this address

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About NPI 1437347457

Shahram Fazilat, DDS's National Provider Identifier is 1437347457, issued on Oct 4, 2007. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Vancouver, WA. The record was last updated on Oct 4, 2007.