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General NPI Number Information
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NPI Number | 1639890940
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Entity Type | Organization
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Legal Business Name | BEND DENTAL CARE, PC
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 965 SW EMKAY DR STE 100
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City | BEND
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State | OR
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Zip | 97702-3598
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Country | US
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Telephone | 541-541-6405
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Fax |
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Provider Business Mailing Address
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Address Line | 660 NE 3RD ST STE 3
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City | BEND
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State | OR
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Zip | 97701-4772
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Country | US
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Telephone | 541-410-1052
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Fax | 541-389-1880
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRADLEY WAYNE HESTER
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Credential | DMD
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Telephone | 541-410-1052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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