Organization
BUNKIE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN ASHLEY JOHNSON DDS (OWNER/DENTIST)
(318) 346-9585
Entity
Organization
Contact information
Practice address
1002 NW MAIN ST, BUNKIE, LA 71322-1519
(318) 346-9585
(318) 346-9596
Mailing address
1002 NW MAIN ST, BUNKIE, LA 71322-1519
(318) 346-9585
(318) 346-9596
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3827361
—
LA
Enumeration date
09/08/2022
Last updated
09/08/2022
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