Organization
PRECIDENT, PLLC
Active
Parent organization
ORAL & FACIAL SURGERY CENTER PA
Other names
INTEGRATIVE DENTAL SPECIALISTS PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORAL & FACIAL SURGERY CENTER PA
Authorized official
DR. SCOTTY L BOLDING D.D.S. (OWNER)
(479) 957-4611
Entity
Organization
Contact information
Practice address
3333 S PINNACLE HILLS PKWY STE 140, ROGERS, AR 72758-8953
(479) 755-3000
(479) 616-1914
Mailing address
PO BOX 8549, FAYETTEVILLE, AR 72703-0010
(479) 755-3000
(479) 616-1914
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
3025
AR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Enumeration date
10/30/2017
Last updated
10/11/2022
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