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NPI 1669580692

NPI 1669580692 : RONALD E. BOSHER DDS : PLANO, TX

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General NPI Number Information
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    NPI Number           |    1669580692
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    Entity Type          |    Organization 
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    Legal Business Name  |    RONALD E. BOSHER DDS 
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Dates
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    Enumeration Date     |    08/29/2006
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    Last Update Date     |    07/30/2008
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Provider Practice Location Address
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    Address Line         |    4701 W PARKER RD SUITE 600
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    City                 |    PLANO
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    State                |    TX
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    Zip                  |    75093-3376
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    Country              |    US
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    Telephone            |    972-985-0005
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    Fax                  |    972-985-0012
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Provider Business Mailing Address
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    Address Line         |    4701 W PARKER RD SUITE 600
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    City                 |    PLANO
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    State                |    TX
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    Zip                  |    75093-3376
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    Country              |    US
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    Telephone            |    972-985-0005
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    Fax                  |    972-985-0012
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Authorized Official
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    Title or Position    |    DENTIST
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    Name                 |    DR. RONALD EVERETT BOSHER 
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    Credential           |    D.D.S.
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    Telephone            |    972-985-0005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    10941
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    License Number State |    TX
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