# DEHAVEN FAMILY DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457810335
- **Authorized official:** DR. WILLIAM R LITTLE DDS (CO-OWNER)
- **Authorized official phone:** (870) 243-4406

## Contact information

- **Practice address:** 3225 NICHOL AVE, ANDERSON, IN 46011-3148
- **Practice address phone:** (765) 642-7717
- **Mailing address:** 3225 NICHOL AVE, ANDERSON, IN 46011-3148
- **Mailing address phone:** (765) 642-7717

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 03/19/2019
- **Last updated:** 03/19/2019