Individual
DR. ANDREA L. LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
750 MORTON BLVD, HAZARD, KY 41701
(606) 439-3557
Mailing address
800 ROSE ST # D104, LEXINGTON, KY 40536-7001
(859) 323-3368
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6909
KY
1223G0001X
General Practice Dentistry
Primary
6909
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45609724
MEDICAID EPSDT
KY
05
—
60069093
—
KY
Enumeration date
01/16/2007
Last updated
02/26/2020
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