Provider Demographics
NPI:1255412482
Name:SKAGIT ENDODONTICS LLC
Entity type:Organization
Organization Name:SKAGIT ENDODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:VOLWILER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:360-757-3636
Mailing Address - Street 1:205 W FAIRHAVEN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-1062
Mailing Address - Country:US
Mailing Address - Phone:360-757-3636
Mailing Address - Fax:360-757-1132
Practice Address - Street 1:205 W FAIRHAVEN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-1062
Practice Address - Country:US
Practice Address - Phone:360-757-3636
Practice Address - Fax:360-757-1132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA63401223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty