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Organization
ENDODONTICS OF SOUTHEASTERN WA, PLLC
Active
Organization
ENDODONTICS OF SOUTHEASTERN WA, PLLC
Active
Other names
Advanced Endodontic Care, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA K BASCOM DDS (OWNER)
(509) 735-9735
Entity
Organization
Contact information
Practice address
10505 W CLEARWATER AVE, BLDG. A, KENNEWICK, WA 99336-8613
(509) 735-9735
(509) 735-9598
Mailing address
10505 W CLEARWATER AVE, BLDG. A, KENNEWICK, WA 99336-8613
(509) 735-9735
(509) 735-9598
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
10481
WA
1223E0200X
Endodontics
Primary
7350
WA
1223E0200X
Endodontics
8842
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164582722
JAMES E. LEONARD, DDS
—
01
—
1245390996
LINDA K. BASCOM, DDS
—
01
—
1386692556
ROLF M.W. WUERCH, DDS
—
Enumeration date
07/16/2008
Last updated
07/16/2008
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