Individual
STEPHEN ALLEN MODELEVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
906 OSLER DRIVE, JONESBORO, AR 72401
(870) 972-8570
(870) 972-5451
Mailing address
PO BOX 1920, JONESBORO, AR 72403
(870) 972-8570
(870) 972-5451
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
2302
AR
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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