Healthcare Provider Details

I. General information

NPI: 1932235223
Provider Name (Legal Business Name): DAVID A. COWLING DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 11/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1297 SHREVEPORT BARKSDALE HWY
SHREVEPORT LA
71105-2405
US

IV. Provider business mailing address

216 WINDCREST DR
MALVERN AR
72104-6153
US

V. Phone/Fax

Practice location:
  • Phone: 318-865-8725
  • Fax: 318-869-4725
Mailing address:
  • Phone: 501-337-7666
  • Fax: 501-337-5668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3239
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30-022870
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12011236A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6082
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number08598
License Number StateIA
# 6
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number24405
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5945
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: