Organization
SHAHRAM GHAFGHAZI DDS,PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHRAM GHAFGHAZI (PRESIDENT)
(617) 605-5655
Entity
Organization
Contact information
Practice address
14257 AMBAUM BLVD SW # 201, BURIEN, WA 98166-1421
(617) 605-5655
Mailing address
14257 AMBAUM BLVD SW # 201, BURIEN, WA 98166-1421
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE00010518
WA
Other
Enumeration date
09/20/2008
Last updated
09/20/2008
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