Provider Demographics
NPI:1740277540
Name:MAINHURST, RONALD RAYMOND (DMD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:RAYMOND
Last Name:MAINHURST
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18412
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60055-8412
Mailing Address - Country:US
Mailing Address - Phone:866-525-5484
Mailing Address - Fax:833-394-4961
Practice Address - Street 1:2647 LOCUST ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1411
Practice Address - Country:US
Practice Address - Phone:855-751-8879
Practice Address - Fax:833-529-0574
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO014599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist