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Individual
DR. MICHAEL BASHOURA
Active
Individual
DR. MICHAEL BASHOURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2017019368
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
62076
KS
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2017019368
MO
Other
Enumeration date
06/24/2017
Last updated
08/22/2025
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