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General NPI Number Information
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NPI Number | 1407470743
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Entity Type | Individual
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Provider Name | TARA RENAE LITTLEFIELD DDS
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Gender | Female
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 1316 E 41ST ST
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City | TULSA
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State | OK
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Zip | 74105-4032
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Country | US
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Telephone | 918-743-1777
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Fax |
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Provider Business Mailing Address
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Address Line | 1316 E 41ST ST
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City | TULSA
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State | OK
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Zip | 74105-4032
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Country | US
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Telephone | 918-743-1777
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | T-7345
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7345
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License Number State | OK
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