Provider Demographics
NPI:1932235223
Name:COWLING, DAVID A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:COWLING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 WINDCREST DR
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-6153
Mailing Address - Country:US
Mailing Address - Phone:501-337-7666
Mailing Address - Fax:501-337-5668
Practice Address - Street 1:1297 SHREVEPORT BARKSDALE HWY
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2405
Practice Address - Country:US
Practice Address - Phone:318-865-8725
Practice Address - Fax:318-869-4725
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR32391223G0001X
OH30-0228701223G0001X
IN12011236A1223G0001X
OK60821223G0001X
IA085981223G0001X
TX244051223G0001X
LA59451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR131715608Medicaid