McQueen Dental PLLC
Clinic/Center, Dental in Fayetteville, AR. Organization (NPI-2).
NPI number1497245997
StatusActive
Last updated in NPPESMay 10, 2018
Details
- NPI
- 1497245997
- Entity type
- Organization (NPI-2)
- Legal business name
- McQueen Dental PLLC
- Organization subpart
- No
- Enumeration date
- May 10, 2018
- Last updated
- May 10, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 4178 | AR | Yes |
Other names
- Bold Dental (Doing Business As)
Practice location
640 N Garland AveFayetteville, AR 72701-3116
Phone 479-521-2653
Mailing address
3321 Indian Springs AveSpringdale, AR 72762-8852
Phone 870-926-0471
Authorized official
Van Michael McQueen
Owner
8709260471
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 7 Dental Clinic/Center providers in Fayetteville · All 4,767 providers in Fayetteville
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