| NPI | 1205255403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT L BOLDING Owner 479-717-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 3025) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-21 |