Individual
DR. MICHAEL LITTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1005 E LASALLE AVE, SOUTH BEND, IN 46617-2818
(574) 245-7501
(574) 245-7502
Mailing address
1005 E LASALLE AVE, SOUTH BEND, IN 46617-2818
(574) 245-7501
(574) 245-7502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12010105
IN
1223G0001X
General Practice Dentistry
Primary
2013000825
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200431870
—
IN
Enumeration date
07/18/2006
Last updated
01/12/2016
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