Individual
DR. MARTHA MARGARET YALLALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1717 BROADMOOR DR, CHAMPAIGN, IL 61821-5933
(217) 359-5771
Mailing address
1717 BROADMOOR DR, CHAMPAIGN, IL 61821-5933
(217) 359-5771
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019020875
IL
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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