Organization
BOLD DENTAL PARTNERS, PLLC FT. SMITH
Active
Parent organization
BOLD DENTAL PARTNERS, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOLD DENTAL PARTNERS, PLLC
Authorized official
JACLYN WHITE (CREDENTIALING MANAGER)
(479) 717-1047
Entity
Organization
Contact information
Practice address
8309 PHOENIX AVE, FORT SMITH, AR 72903-6141
(479) 484-7645
(479) 484-1551
Mailing address
8309 PHOENIX AVE, FORT SMITH, AR 72903-6141
(479) 484-7645
(479) 484-1551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3242
AR
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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