| NPI | 1437646908 |
|---|---|
| Former Legal Business Name | BOLDT DENTAL |
| Entity Type | Organization |
| Authorized Contact | ANTHONY MARK PAVENTY Owner 509-475-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9209) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |