Provider Demographics
NPI:1013016492
Name:NOE, JOHN SLOANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SLOANE
Last Name:NOE
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:PO BOX 1049
Mailing Address - Street 2:
Mailing Address - City:WALNUT GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95690-1049
Mailing Address - Country:US
Mailing Address - Phone:916-776-2131
Mailing Address - Fax:916-776-2135
Practice Address - Street 1:14137 TYLER STREET
Practice Address - Street 2:
Practice Address - City:WALNUT GROVE
Practice Address - State:CA
Practice Address - Zip Code:95690
Practice Address - Country:US
Practice Address - Phone:916-776-2131
Practice Address - Fax:916-776-2135
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42203122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist