Dr. Jack O. Smalley Dss
NPI #1063989531 in Farmington, New Mexico
Provider Information
- NPI Number
- 1063989531
- Entity Type
- Organization
- Organization Name
- Dr. Jack O. Smalley Dss
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 1, 2018
- Last Updated
- Nov 1, 2018
Practice Location
- Address
- 2650 E PINON FRONTAGE RD BLDG 300
- City
- Farmington
- State
- New Mexico
- ZIP Code
- 87402-5084
- Phone
- (505) 327-3331
Authorized Official
- Name
- MS. DEANZA D SONA, RDA
- Title
- OFFICE MANAGER
- Phone
- (505) 327-3331
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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