Provider Demographics
NPI:1639890940
Name:BEND DENTAL CARE, PC
Entity Type:Organization
Organization Name:BEND DENTAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-410-1052
Mailing Address - Street 1:660 NE 3RD ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4772
Mailing Address - Country:US
Mailing Address - Phone:541-410-1052
Mailing Address - Fax:541-389-1880
Practice Address - Street 1:965 SW EMKAY DR STE 100
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3598
Practice Address - Country:US
Practice Address - Phone:541-541-6405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty