| 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 |