Organization
SOUTHEASTERN OVERREAD SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALLAS A SMITH JR. MD (PRESIDENT)
(336) 852-3488
Entity
Organization
Contact information
Practice address
3723 W MARKET ST, SUITE A, GREENSBORO, NC 27403-1590
(336) 852-3488
(336) 852-3442
Mailing address
PO BOX 16566, CHAPEL HILL, NC 27516-6566
(919) 967-6646
(919) 967-6647
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013TR
BLUE CROSS/BLUE SHIELD
NC
05
—
89013TR
—
NC
Enumeration date
06/11/2006
Last updated
08/22/2020
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