Provider Demographics
NPI:1285792184
Name:LITTLE, JOHN P (DMD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:LITTLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 HIGHWAY 71
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-2807
Mailing Address - Country:US
Mailing Address - Phone:732-449-6564
Mailing Address - Fax:732-449-8606
Practice Address - Street 1:804 HIGHWAY 71
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-2807
Practice Address - Country:US
Practice Address - Phone:732-449-6564
Practice Address - Fax:732-449-8606
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ186461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice