Organization
MODELEVSKY DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERI MODELEVSKY JD (OFFICE MANAGER)
(870) 972-8570
Entity
Organization
Contact information
Practice address
906 OSLER DR, JONESBORO, AR 72401-4366
(870) 972-8570
(870) 972-5451
Mailing address
PO BOX 1920, JONESBORO, AR 72403-1920
(870) 972-8570
(870) 972-5451
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
2302
AR
Other
Enumeration date
06/06/2008
Last updated
06/19/2012
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