Provider Demographics
NPI:1528200151
Name:MONICA NOBLES, DDS, PA
Entity Type:Organization
Organization Name:MONICA NOBLES, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:SHERRIE
Authorized Official - Last Name:NOBLES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-734-8666
Mailing Address - Street 1:PO BOX 24268
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76124-1268
Mailing Address - Country:US
Mailing Address - Phone:817-734-8666
Mailing Address - Fax:817-451-9912
Practice Address - Street 1:1801 EASTCHASE PKWY
Practice Address - Street 2:SUITE 119
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-4424
Practice Address - Country:US
Practice Address - Phone:817-734-8666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty