Organization
SOUTHEAST FAMILY DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M LALLY DDS (MBR)
(870) 222-3926
Entity
Organization
Contact information
Practice address
601 N 2ND ST, MC GEHEE, AR 71654-2005
(870) 222-3926
(870) 222-4002
Mailing address
601 N 2ND ST, MC GEHEE, AR 71654-2005
(870) 222-3926
(870) 222-4002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2164
AR
1223G0001X
General Practice Dentistry
4106
AR
Other
Enumeration date
08/06/2016
Last updated
08/06/2016
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