Provider Demographics
NPI:1053426221
Name:BASHOR, RONALD LESLIE (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LESLIE
Last Name:BASHOR
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 COUNTRY CLUB DRIVE
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:MO
Mailing Address - Zip Code:64730
Mailing Address - Country:US
Mailing Address - Phone:660-679-6905
Mailing Address - Fax:
Practice Address - Street 1:619 W NURSERY
Practice Address - Street 2:BATES COUNTY DENTAL CENTER
Practice Address - City:BUTLER
Practice Address - State:MO
Practice Address - Zip Code:64730
Practice Address - Country:US
Practice Address - Phone:660-679-6767
Practice Address - Fax:660-679-6811
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO012482122300000X
MO028286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered183500000XPharmacy Service ProvidersPharmacist