Southern Magnolia Dentistry | |
3215 Masonic Dr Alexandria LA 71301-4246 | |
(318) 229-3121 | |
Not Available |
Full Name | Southern Magnolia Dentistry |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 3215 Masonic Dr, Alexandria, Louisiana |
Authorized Official Name and Position | Akeele Johnson-vallot (OWNER) |
Authorized Official Contact | 3182293121 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Southern Magnolia Dentistry 3215 Masonic Dr Alexandria LA 71301-4246 Ph: (318) 229-3121 | Southern Magnolia Dentistry 3215 Masonic Dr Alexandria LA 71301-4246 Ph: (318) 229-3121 |
NPI Number | 1598545386 |
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Provider Enumeration Date | 09/29/2023 |
Last Update Date | 10/02/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598545386 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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