Provider Demographics
NPI:1659769933
Name:GLENN A NOBLE DDS PC
Entity Type:Organization
Organization Name:GLENN A NOBLE DDS PC
Other - Org Name:TRYON FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-859-5839
Mailing Address - Street 1:70 DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-3358
Mailing Address - Country:US
Mailing Address - Phone:828-859-5839
Mailing Address - Fax:828-859-5502
Practice Address - Street 1:70 DEPOT ST
Practice Address - Street 2:
Practice Address - City:TRYON
Practice Address - State:NC
Practice Address - Zip Code:28782-3358
Practice Address - Country:US
Practice Address - Phone:828-859-5839
Practice Address - Fax:828-859-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9912122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty