| Organization Name: | ORAL & FACIAL SURGERY CENTER PA |
| NPI Number: | 1891744462 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SCOTT L BOLDING (OWNER) |
| Mailing Address: | 2926 W Huntsville Ave Springdale |
| State: | AR US |
| Postal Code: | 727627726 |
| Phone Number: | 4799273030 |
| Fax Number: | 4799273085 |
| NPI Enumeration Date: | 05/09/2006 |
| NPI Last Update Date: | 06/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |