Organization
TARUNA S BOLDING DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARUNA S BOLDING DDS (OWNER)
(479) 957-4612
Entity
Organization
Contact information
Practice address
5229 SAINT ANDREWS DR, FAYETTEVILLE, AR 72704-6219
(479) 957-4612
Mailing address
5229 SAINT ANDREWS DR, FAYETTEVILLE, AR 72704-6219
(479) 957-4612
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3062
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163704608
—
AR
01
—
3062
AR DENTAL LICENSE
AR
Enumeration date
11/15/2017
Last updated
12/27/2021
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