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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