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Organization
PRECIDENT OF NEW JERSEY, LLC
Active
Organization
PRECIDENT OF NEW JERSEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTTY L BOLDING DDS, MS (OWNER)
(479) 957-4611
Entity
Organization
Contact information
Practice address
1135 BROAD ST STE 100, CLIFTON, NJ 07013-3346
(973) 256-0103
(973) 256-8066
Mailing address
PO BOX 2714, DEPT 2243, CONWAY, AR 72033-2714
(973) 256-0103
(973) 256-8066
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Enumeration date
07/02/2021
Last updated
05/12/2023
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