Provider Demographics
NPI:1073765590
Name:BOSHER, RONALD E (DDS)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:E
Last Name:BOSHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4709 W PARKER RD
Mailing Address - Street 2:SUITE 515
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3368
Mailing Address - Country:US
Mailing Address - Phone:972-985-0005
Mailing Address - Fax:972-985-0012
Practice Address - Street 1:4709 W PARKER RD
Practice Address - Street 2:SUITE 515
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3368
Practice Address - Country:US
Practice Address - Phone:972-985-0005
Practice Address - Fax:972-985-0012
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice