Provider Demographics
NPI:1154045599
Name:PRECIDENT FLORIDA PLLC
Entity type:Organization
Organization Name:PRECIDENT FLORIDA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOLDING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-957-4611
Mailing Address - Street 1:10601 SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3329
Mailing Address - Country:US
Mailing Address - Phone:727-397-8503
Mailing Address - Fax:727-398-2679
Practice Address - Street 1:10601 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-3329
Practice Address - Country:US
Practice Address - Phone:727-397-8503
Practice Address - Fax:727-398-2679
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECIDENT FLORIDA PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-29
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty