Provider Demographics
NPI:1801034285
Name:STAN P. COWLEY, JR, DDS
Entity type:Organization
Organization Name:STAN P. COWLEY, JR, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:COWLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-831-4895
Mailing Address - Street 1:3237 METAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5214
Mailing Address - Country:US
Mailing Address - Phone:504-831-4895
Mailing Address - Fax:504-831-5957
Practice Address - Street 1:3237 METAIRIE RD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5214
Practice Address - Country:US
Practice Address - Phone:504-831-4895
Practice Address - Fax:504-831-5957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA54721223G0001X
LA26981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty