Provider Demographics
NPI:1750599346
Name:LITTLEFIELD, DAVID BRYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRYAN
Last Name:LITTLEFIELD
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 1:890 EASTLAKE PARKWAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-1209
Mailing Address - Country:US
Mailing Address - Phone:619-420-0050
Mailing Address - Fax:
Practice Address - Street 1:890 EASTLAKE PARKWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-1209
Practice Address - Country:US
Practice Address - Phone:619-420-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA036094122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist