Provider Demographics
NPI:1366643512
Name:LITTEKEN, SUSAN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:E
Last Name:LITTEKEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 FIRST CAPITOL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2734
Mailing Address - Country:US
Mailing Address - Phone:636-724-0220
Mailing Address - Fax:
Practice Address - Street 1:928 FIRST CAPITOL DRIVE
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2734
Practice Address - Country:US
Practice Address - Phone:636-724-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODEN015234122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist