Individual
FREDERICK C. LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S,
Contact information
Practice address
164 W TIOGA ST, TUNKHANNOCK, PA 18657-1466
(570) 836-6362
Mailing address
164 W TIOGA ST, TUNKHANNOCK, PA 18657-1466
(570) 836-6362
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS020916-L
PA
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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