Provider Demographics
NPI:1437375383
Name:NEIL, KAREN LITTLEFIELD (DDS)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LITTLEFIELD
Last Name:NEIL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LEIGH
Other - Last Name:LITTLEFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3600 HULEN
Mailing Address - Street 2:SUITE C1
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107
Mailing Address - Country:US
Mailing Address - Phone:817-738-3368
Mailing Address - Fax:817-731-4674
Practice Address - Street 1:3600 HULEN
Practice Address - Street 2:SUITE C1
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107
Practice Address - Country:US
Practice Address - Phone:817-738-3368
Practice Address - Fax:817-731-4674
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14949122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA474404OtherUNITED CONCORDIA INS CO
TXD14949OtherBCBS FEDERAL