Provider Demographics
NPI:1992997308
Name:LITTLE, GEORGE N (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:N
Last Name:LITTLE
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 1:7 REDWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROSS
Mailing Address - State:CA
Mailing Address - Zip Code:94957
Mailing Address - Country:US
Mailing Address - Phone:415-925-2545
Mailing Address - Fax:415-925-9220
Practice Address - Street 1:7 REDWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:ROSS
Practice Address - State:CA
Practice Address - Zip Code:94957
Practice Address - Country:US
Practice Address - Phone:415-925-2545
Practice Address - Fax:415-925-9220
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42847122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist