Provider Demographics
NPI:1326602400
Name:SLEEP BOLD ARKANSAS LLC
Entity type:Organization
Organization Name:SLEEP BOLD ARKANSAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:BOLDING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-230-0938
Mailing Address - Street 1:407 LLAMA DR STE 103
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4786
Mailing Address - Country:US
Mailing Address - Phone:501-230-0938
Mailing Address - Fax:
Practice Address - Street 1:407 LLAMA DR STE 103
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4786
Practice Address - Country:US
Practice Address - Phone:501-230-0938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty