MEDICARE: RONALD E. BOSHER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	10941	TX

General Provider Information

NPI Number	:	1669580692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD E. BOSHER DDS

Provider Business Mailing Address
First Line	:	4701 W PARKER RD
Second Line	:	SUITE 600
City	:	PLANO
State	:	TX
Zip	:	75093-3376
Country	:	US
Telephone Number	:	972-985-0005
Fax Number	:	972-985-0012

Provider Business Practice Location Address
First Line	:	4701 W PARKER RD
Second Line	:	SUITE 600
City	:	PLANO
State	:	TX
Zip	:	75093-3376
Country	:	US
Telephone Number	:	972-985-0005
Fax Number	:	972-985-0012

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. RONALD EVERETT BOSHER
Credential	:	D.D.S.
Telephone Number	:	972-985-0005

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	07/30/2008

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