| NPI | 1720326945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT L BOLDING President 479-434-4430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 3025) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2014-09-10 |