Carla C Couri, D.M.D.
Individual provider Active NPI General Practice Dentistry · Peoria, IL
NPI 1174693287 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1174693287
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 4408 N Knoxville Ave
Ste D
Peoria, IL 61614-6084 - Phone
- (309) 682-5522
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019024444 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carla C. Couri, D.M.D., LTD. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
4408 N Knoxville Ave
Ste D
Peoria, IL 61614-6084
Mailing address
4408 N Knoxville Ave
Ste D
Peoria, IL 61614-6084
Phone (309) 682-5522
Other providers in Peoria, IL
- Countermeasures, Inc.
- County of Peoria
- Maggie Cour
- Couri Center for Gynecology and Integrative Womens Health SC
- Candace Couri
- Christopher Joseph Couri
- Felicia Sadie Couri
- Gene G Couri
- Joseph Couri
- Michele A Couri
All providers in Peoria, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.