# ENDODONTICS OF SOUTHEASTERN WA, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Endodontic Care, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437313616
- **Authorized official:** DR. LINDA K BASCOM DDS (OWNER)
- **Authorized official phone:** (509) 735-9735

## Contact information

- **Practice address:** 10505 W CLEARWATER AVE, BLDG. A, KENNEWICK, WA 99336-8613
- **Practice address phone:** (509) 735-9735
- **Practice address fax:** (509) 735-9598
- **Mailing address:** 10505 W CLEARWATER AVE, BLDG. A, KENNEWICK, WA 99336-8613
- **Mailing address phone:** (509) 735-9735
- **Mailing address fax:** (509) 735-9598

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 10481 | WA | — |
| 1223E0200X | Endodontics | 7350 | WA | Yes |
| 1223E0200X | Endodontics | 8842 | WA | — |

## Other

- **Enumeration date:** 07/16/2008
- **Last updated:** 07/16/2008

## 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 | — |