Provider Demographics
NPI:1780679456
Name:LITTLE, PAT R (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAT
Middle Name:R
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 1:318 ORCHARD WAY SE
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-4587
Mailing Address - Country:US
Mailing Address - Phone:706-277-1671
Mailing Address - Fax:
Practice Address - Street 1:1020 CHATTANOOGA AVE
Practice Address - Street 2:STE D
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8880
Practice Address - Country:US
Practice Address - Phone:706-277-1671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0103391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice