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NPI Code Detail

MEDICARE: MR. PETER LEE COUVILLON DDS

MEDICARE: MR. PETER LEE COUVILLON DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry3132LA

General Provider Information

NPI Number : 1427159870
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PETER LEE COUVILLON DDS
Provider Business Mailing Address
First Line : 1312 HOLLY ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-6941
Country : US
Telephone Number : 318-443-7062
Fax Number :
Provider Business Practice Location Address
First Line : 1312 HOLLY ST
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-6941
Country : US
Telephone Number : 318-443-7062
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/08/2007

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Directions to “ MR. PETER LEE COUVILLON DDS” Practice Location

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