Individual
DR. LESLIE REENE BASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
209 S 7TH ST, WORLAND, WY 82401-3307
(307) 347-2544
(307) 347-2352
Mailing address
517 S 9TH ST, THERMOPOLIS, WY 82443-3046
(307) 864-2653
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
876
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
301685
BLUE CROSS BLUE SHIELD
WY
Enumeration date
03/22/2007
Last updated
07/09/2007
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