Organization
BASIC DENTAL CARE OF WALLA WALLA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIS L LAIZURE DMD (OWNER)
(509) 525-4833
Entity
Organization
Contact information
Practice address
2014 S HOWARD ST STE D, WALLA WALLA, WA 99362-4532
(509) 525-9111
(509) 525-0832
Mailing address
2014 S HOWARD ST STE D, WALLA WALLA, WA 99362-4532
(509) 525-9111
(509) 525-0832
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4946
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5056833
—
WA
Enumeration date
04/13/2010
Last updated
04/13/2010
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