Organization
BOLD DENTAL POTTSVILLE
Active
Parent organization
BOLD DENTAL PARTNERS, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOLD DENTAL PARTNERS, PLLC
Authorized official
WENDY PEDUTO (TRANSITION MANAGER)
(501) 436-0518
Entity
Organization
Contact information
Practice address
7146 SR 247, POTTSVILLE, AR 72858-8891
(479) 858-7382
Mailing address
7146 SR 247, POTTSVILLE, AR 72858-8891
(479) 858-7382
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
AR
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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