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General NPI Number Information
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NPI Number | 1184954422
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Entity Type | Organization
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Legal Business Name | KAMRAN HAGHIGHAT BDS MS PC
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Dates
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Enumeration Date | 01/08/2010
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Last Update Date | 01/08/2010
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Provider Practice Location Address
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Address Line | 833 SW 11TH AVE STE 1020
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City | PORTLAND
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State | OR
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Zip | 97205-2124
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Country | US
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Telephone | 503-224-3853
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Fax | 503-226-6832
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Provider Business Mailing Address
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Address Line | 833 SW 11TH AVE STE 1020
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City | PORTLAND
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State | OR
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Zip | 97205-2124
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Country | US
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Telephone | 503-224-3853
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Fax | 503-226-6832
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Authorized Official
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Title or Position | OWNER
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Name | DR. KAMRAN HAGHIGHAT
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Credential | BDS MS PC
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Telephone | 503-224-3853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | D8397
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License Number State | OR
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