Provider Demographics
NPI:1982707121
Name:LITTLEFIELD, ERIC W (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:W
Last Name:LITTLEFIELD
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 1:911 11TH AVE
Mailing Address - Street 2:STE C
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632
Mailing Address - Country:US
Mailing Address - Phone:360-577-0770
Mailing Address - Fax:360-577-0140
Practice Address - Street 1:911 11TH AVE
Practice Address - Street 2:STE C
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632
Practice Address - Country:US
Practice Address - Phone:360-577-0770
Practice Address - Fax:360-577-0140
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA74381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice