Provider Demographics
NPI:1760474761
Name:NOBLE, PATRICK CHRISTIAN (DMD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:CHRISTIAN
Last Name:NOBLE
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 1:31 OLD ETNA RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1933
Mailing Address - Country:US
Mailing Address - Phone:603-448-0553
Mailing Address - Fax:603-448-0553
Practice Address - Street 1:31 OLD ETNA RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1933
Practice Address - Country:US
Practice Address - Phone:603-448-0553
Practice Address - Fax:603-448-0553
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH35871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
044451OtherLICENSE #
NH3587OtherSTATE LICENSE