Healthcare Provider Details

I. General information

NPI: 1144392788
Provider Name (Legal Business Name): STEVEN F MOLPUS DDS, PLC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 10/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 CRESTWOOD RD STE 302
N LITTLE ROCK AR
72116-7617
US

IV. Provider business mailing address

2501 CRESTWOOD RD STE 302
N LITTLE ROCK AR
72116-7617
US

V. Phone/Fax

Practice location:
  • Phone: 501-771-4631
  • Fax: 501-771-4682
Mailing address:
  • Phone: 501-771-4631
  • Fax: 501-771-4682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3305
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: