Provider Demographics
NPI:1922239862
Name:RASBAND, WILLIAM SPENCER (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SPENCER
Last Name:RASBAND
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 1:202 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-2018
Mailing Address - Country:US
Mailing Address - Phone:816-651-7743
Mailing Address - Fax:
Practice Address - Street 1:202 N MAIN ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-2018
Practice Address - Country:US
Practice Address - Phone:816-651-7743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS611361223G0001X
NMDD3160122300000X
NMCS00214717122300000X
CODEN.002019291223G0001X, 1223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health