# BOLD DENTAL PARTNERS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619311198
- **Authorized official:** DR. SCOTT L BOLDING DDS (OWNER)
- **Authorized official phone:** (479) 521-2653

## Contact information

- **Practice address:** 640 N GARLAND AVE, SUITE 104, FAYETTEVILLE, AR 72701
- **Practice address phone:** (479) 521-2653
- **Practice address fax:** (479) 575-0380
- **Mailing address:** PO BOX 1108, FAYETTEVILLE, AR 72702-1108
- **Mailing address phone:** (479) 439-9192
- **Mailing address fax:** (479) 725-2395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3062 | AR | Yes |

## Other

- **Enumeration date:** 04/26/2013
- **Last updated:** 08/28/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 163704608 | — | AR |