Provider Demographics
NPI:1013967363
Name:LITTLE, CRAIG NEWELLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:NEWELLE
Last Name:LITTLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403A W 4TH NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6547
Mailing Address - Country:US
Mailing Address - Phone:843-821-7583
Mailing Address - Fax:843-821-6355
Practice Address - Street 1:403A W 4TH NORTH ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6547
Practice Address - Country:US
Practice Address - Phone:843-821-7583
Practice Address - Fax:843-821-6355
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30-27381223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZA9743Medicaid