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General NPI Number Information
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NPI Number | 1831967629
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Entity Type | Organization
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Legal Business Name | LITTLE TOOTH CO PLLC
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 3920 E 91ST ST
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City | TULSA
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State | OK
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Zip | 74137-3602
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Country | US
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Telephone | 918-496-2481
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Fax |
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Provider Business Mailing Address
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Address Line | 3920 E 91ST ST
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City | TULSA
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State | OK
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Zip | 74137-3602
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Country | US
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Telephone | 918-496-2481
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JOSHUA BRASHER
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Credential | DDS
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Telephone | 405-250-2255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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