Organization
AZITA SHAHGALDI DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZITA SHAHGALDI (DENTIST)
(503) 246-7999
Entity
Organization
Contact information
Practice address
9600 SW CAPITOL HWY, 140, PORTLAND, OR 97219-5295
(503) 246-7999
(503) 546-2976
Mailing address
9600 SW CAPITOL HWY, 140, PORTLAND, OR 97219-5295
(503) 246-7999
(503) 546-2976
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D9511
OR
Other
Enumeration date
12/12/2012
Last updated
12/12/2012
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