Provider Demographics
NPI:1881452878
Name:HESTER MAINSTAY
Entity type:Organization
Organization Name:HESTER MAINSTAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF DENTAL OFFICER
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 1:20101 WINSTON LOOP
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-8990
Mailing Address - Country:US
Mailing Address - Phone:541-410-1052
Mailing Address - Fax:
Practice Address - Street 1:21 CASCADE DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-3765
Practice Address - Country:US
Practice Address - Phone:541-451-1991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental