Organization
DR. JACK SMALLEY D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEANZA DAWN SONA (OFFICE MANAGER)
(505) 327-3331
Entity
Organization
Contact information
Practice address
1700 N BUTLER AVE, FARMINGTON, NM 87401-6331
(505) 327-3331
(505) 327-0873
Mailing address
1700 N BUTLER AVE, FARMINGTON, NM 87401-6331
(505) 327-3331
(505) 327-0873
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1918
NM
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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