MEDICARE: LITTON FAMILY DENTAL. PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	23997	TX
2	261QD0000X	Dental Clinic/Center		TX

General Provider Information

NPI Number	:	1174043913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTON FAMILY DENTAL. PLLC

Provider Business Mailing Address
First Line	:	457 LANDA ST STE I
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-5414
Country	:	US
Telephone Number	:	830-625-4313
Fax Number	:	830-625-5518

Provider Business Practice Location Address
First Line	:	457 LANDA ST STE I
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-5414
Country	:	US
Telephone Number	:	830-625-4313
Fax Number	:	830-625-5518

Authorized Official
Title or Position	:	DENTIST
Name	:	CHANCE WADE LITTON
Credential	:
Telephone Number	:	830-625-4313

Provider Enumeration Date	:	06/22/2017
Last Update Date	:	02/04/2025

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