Provider Demographics
NPI:1477926764
Name:NOBLE, ALISON (RDH, EPDH)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:NOBLE
Suffix:
Gender:F
Credentials:RDH, EPDH
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 384
Mailing Address - Street 2:
Mailing Address - City:SILETZ
Mailing Address - State:OR
Mailing Address - Zip Code:97380-0384
Mailing Address - Country:US
Mailing Address - Phone:541-272-7946
Mailing Address - Fax:
Practice Address - Street 1:178 SW TILLAMOOK ST.
Practice Address - Street 2:
Practice Address - City:SILETZ
Practice Address - State:OR
Practice Address - Zip Code:97380-0384
Practice Address - Country:US
Practice Address - Phone:541-272-7946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6898124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist