Provider Demographics
NPI:1376664599
Name:NOGLE, MATTHEW T (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:T
Last Name:NOGLE
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 1:6349 BUNNELL HILL RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9034
Mailing Address - Country:US
Mailing Address - Phone:513-641-8075
Mailing Address - Fax:513-891-0678
Practice Address - Street 1:6349 BUNNELL HILL RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-9034
Practice Address - Country:US
Practice Address - Phone:513-641-8075
Practice Address - Fax:513-891-0678
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0215341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice