Provider Demographics
NPI:1598844052
Name:LITTLE, CARL PHILEMON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:PHILEMON
Last Name:LITTLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27260-5146
Mailing Address - Country:US
Mailing Address - Phone:336-889-9953
Mailing Address - Fax:336-889-7893
Practice Address - Street 1:628 E WASHINGTON DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27260-5146
Practice Address - Country:US
Practice Address - Phone:336-889-9953
Practice Address - Fax:336-889-7893
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC66911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice