| Bold Dental | |
|
640 N Garland Ave Fayetteville AR 72701-3116 | |
| (479) 521-2653 | |
| Not Available |
| Full Name | Bold Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 640 N Garland Ave, Fayetteville, Arkansas |
| Authorized Official Name and Position | Van Michael Mcqueen (OWNER) |
| Authorized Official Contact | 8709260471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bold Dental 3321 Indian Springs Ave Springdale AR 72762-8852 Ph: (870) 926-0471 | Bold Dental 640 N Garland Ave Fayetteville AR 72701-3116 Ph: (479) 521-2653 |
| NPI Number | 1497245997 |
|---|---|
| Provider Enumeration Date | 05/10/2018 |
| Last Update Date | 05/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497245997 | NPI | - | NPPES |
| 1518496215 | Other | AR | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4178 (Arkansas) | Primary |
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