| Craig S. Modzelewski Dmd Inc. | |
|
522 Main St N Allendale SC 29810-3720 | |
| (803) 584-2105 | |
| (803) 584-5757 |
| Full Name | Craig S. Modzelewski Dmd Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 522 Main St N, Allendale, South Carolina |
| Authorized Official Name and Position | Craig Steven Modzelewski (PRESIDENT) |
| Authorized Official Contact | 8035842105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Craig S. Modzelewski Dmd Inc. 522 Main St N Allendale SC 29810-3720 Ph: (803) 584-2105 | Craig S. Modzelewski Dmd Inc. 522 Main St N Allendale SC 29810-3720 Ph: (803) 584-2105 |
| NPI Number | 1114163524 |
|---|---|
| Provider Enumeration Date | 01/07/2009 |
| Last Update Date | 01/07/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114163524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3892 (South Carolina) | Primary |
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