Provider Demographics
NPI:1225356306
Name:THOMAS E. LITTNER, D.D.S., P.C.
Entity Type:Organization
Organization Name:THOMAS E. LITTNER, D.D.S., P.C.
Other - Org Name:CORNERSTONE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:LITTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-342-4668
Mailing Address - Street 1:123 ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-5211
Mailing Address - Country:US
Mailing Address - Phone:845-342-4668
Mailing Address - Fax:845-342-0642
Practice Address - Street 1:123 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5211
Practice Address - Country:US
Practice Address - Phone:845-342-4668
Practice Address - Fax:845-342-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0377961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6303980001Medicare NSC