Provider Demographics
NPI:1689643165
Name:NOBLE, STEPHEN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
Last Name:NOBLE
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 2802
Mailing Address - Street 2:
Mailing Address - City:BIG BEAR LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92315-2802
Mailing Address - Country:US
Mailing Address - Phone:909-866-2233
Mailing Address - Fax:909-866-3855
Practice Address - Street 1:40712 BIG BEAR BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:BIG BEAR LAKE
Practice Address - State:CA
Practice Address - Zip Code:92835-4124
Practice Address - Country:US
Practice Address - Phone:909-866-2233
Practice Address - Fax:909-866-3855
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice