| J.m. Lally, Dds, Ltd | |
|
601 N 2nd St Mc Gehee AR 71654-2005 | |
| (870) 222-3926 | |
| Not Available |
| Full Name | J.m. Lally, Dds, Ltd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 601 N 2nd St, Mc Gehee, Arkansas |
| Authorized Official Name and Position | John Lally (OWNER) |
| Authorized Official Contact | 8702223926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J.m. Lally, Dds, Ltd 601 N 2nd St Mc Gehee AR 71654-2005 Ph: (870) 222-3926 | J.m. Lally, Dds, Ltd 601 N 2nd St Mc Gehee AR 71654-2005 Ph: (870) 222-3926 |
| NPI Number | 1730353004 |
|---|---|
| Provider Enumeration Date | 04/17/2008 |
| Last Update Date | 04/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730353004 | NPI | - | NPPES |
| 102093608 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2164 (Arkansas) | Primary |
Southeast Family Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 N 2nd St, Mc Gehee, AR 71654 Phone: 870-222-3926 Fax: 870-222-4002 |