MEDICARE: DR. RICHARD CLAYTON LITT D.D.S.

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	1223G0001X	General Practice Dentistry	30238	NY

General Provider Information

NPI Number	:	1922114933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD CLAYTON LITT D.D.S.

Provider Business Mailing Address
First Line	:	125 LAKE ST LBBY
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604-2419
Country	:	US
Telephone Number	:	914-946-8871
Fax Number	:	914-946-8872

Provider Business Practice Location Address
First Line	:	125 LAKE ST LBBY
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604-2419
Country	:	US
Telephone Number	:	914-946-8871
Fax Number	:	914-946-8872

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	07/08/2007

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