Provider Demographics
NPI:1053020024
Name:LITTLEJOHN, CAROLINE (DMD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 ARCHBISHOP DR
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1325
Mailing Address - Country:US
Mailing Address - Phone:610-246-9413
Mailing Address - Fax:
Practice Address - Street 1:113 ARCHBISHOP DR
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1325
Practice Address - Country:US
Practice Address - Phone:610-246-9413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0437371223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health