Phelan, Stephen Todd

Phelan, Stephen Todd is an individual health care provider with primary practice located at 2102 W Pleasant Grove Rd Suite 1, Rogers AR 72758-8242. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Phelan, Stephen Todd can be contacted via phone (479) 636-3400.

Contact Information

Primary practice address
2102 W Pleasant Grove Rd Suite 1 Rogers AR 72758-8242
Phone: (479) 636-3400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3489 Arkansas

Profile Details

NPI number 1508924903
LBN Legal business name Phelan, Stephen Todd
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated May 6th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508924903 NPPES
Arkansas Other 5Y261 BCBS NUMBER
Arkansas MEDICAID 163953608 BCBS NUMBER

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