Healthcare Provider Details

I. General information

NPI: 1518975598
Provider Name (Legal Business Name): HERBERT M LITTON DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 WILSON MILLS RD. #304
HIGHLANDS HTS. OH
44143
US

IV. Provider business mailing address

6151 WILSON MILLS RD. #304
HIGHLANDS HTS. OH
44143
US

V. Phone/Fax

Practice location:
  • Phone: 440-461-3637
  • Fax: 440-460-1019
Mailing address:
  • Phone: 440-461-3637
  • Fax: 440-460-1019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30 012908
License Number StateOH

VIII. Authorized Official

Name: DR. HERBERT M LITTON
Title or Position: PRESIDENT
Credential: DDS
Phone: 440-461-3637