| 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 |
|---|---|
| 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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