Organization
LITTLE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIQUE TUCKER (DIRECTOR OF INSURANCE)
(843) 990-9998
Entity
Organization
Contact information
Practice address
103 PARK AVE STE 200, POOLER, GA 31322-4262
(912) 988-3655
(866) 475-6212
Mailing address
250 ADLEY WAY, GREENVILLE, SC 29607
(843) 990-9998
(866) 568-4935
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/30/2017
Last updated
01/11/2018
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