Organization
GHAFGHAZI DDS,P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHRAM GHAFGHAZI DDS (PRESIDENT)
(617) 605-5655
Entity
Organization
Contact information
Practice address
1002 PARK AVE N STE H, RENTON, WA 98057-5632
(617) 605-5655
Mailing address
720 N 10TH ST # A-364, RENTON, WA 98057-5525
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE 00010518
WA
Other
Enumeration date
02/26/2012
Last updated
02/26/2012
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