Individual
AKEELE AYANNA JOHNSON-VALLOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
3215 MASONIC DR, ALEXANDRIA, LA 71301-4246
(318) 542-4005
(318) 542-4006
Mailing address
3215 MASONIC DR, ALEXANDRIA, LA 71301-4246
(318) 542-4005
(318) 542-4006
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
62022
CA
1223P0221X
Pediatric Dentistry
Primary
7118
LA
Other
Enumeration date
11/08/2012
Last updated
04/09/2024
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