Provider Demographics
NPI:1861523417
Name:BASQUILL, LINDA C (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:C
Last Name:BASQUILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ASHFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-9091
Mailing Address - Country:US
Mailing Address - Phone:803-333-0895
Mailing Address - Fax:
Practice Address - Street 1:122 N BRICKYARD RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6902
Practice Address - Country:US
Practice Address - Phone:803-736-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3937122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist