Provider Demographics
NPI:1952160301
Name:J LITTLE DDS MSD PLLC
Entity type:Organization
Organization Name:J LITTLE DDS MSD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:269-370-3531
Mailing Address - Street 1:2405 HERRONS NEST PL NW SUITE #113 CONCORD, NC 28027
Mailing Address - Street 2:SUITE #113
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027
Mailing Address - Country:US
Mailing Address - Phone:269-370-3531
Mailing Address - Fax:
Practice Address - Street 1:2405 HERRONS NEST PL NW SUITE #113 CONCORD, NC 28027
Practice Address - Street 2:SUITE #113
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027
Practice Address - Country:US
Practice Address - Phone:269-370-3531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty