Provider Demographics
NPI:1962211748
Name:LITTLE ACORN DENTISTRY FOR KIDS
Entity type:Organization
Organization Name:LITTLE ACORN DENTISTRY FOR KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:801-819-9845
Mailing Address - Street 1:149 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-8614
Mailing Address - Country:US
Mailing Address - Phone:801-819-9845
Mailing Address - Fax:
Practice Address - Street 1:571 VFW MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SAINT ROBERT
Practice Address - State:MO
Practice Address - Zip Code:65584-4841
Practice Address - Country:US
Practice Address - Phone:801-819-9845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty