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General NPI Number Information
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NPI Number | 1467621607
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Entity Type | Individual
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Provider Name | THOMAS D LITTLE DMD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 210 1ST AVE E
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City | KALISPELL
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State | MT
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Zip | 59901-4561
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Country | US
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Telephone | 406-752-2180
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Fax | 406-752-5276
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Provider Business Mailing Address
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Address Line | 210 1ST AVE E
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City | KALISPELL
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State | MT
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Zip | 59901-4561
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Country | US
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Telephone | 406-752-2180
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Fax | 406-752-5276
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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 | 2096
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License Number State | MT
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