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General NPI Number Information
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NPI Number | 1093519209
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Entity Type | Individual
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Provider Name | NATALIE KAY LITTLE DDS
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Gender | Female
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 577 E STATE ST
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City | EAGLE
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State | ID
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Zip | 83616-5938
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Country | US
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Telephone | 208-939-0611
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Fax |
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Provider Business Mailing Address
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Address Line | 314 S HAMLIN LN
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City | EAGLE
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State | ID
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Zip | 83616-4123
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Country | US
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Telephone | 208-559-1390
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2271563
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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