Provider Demographics
NPI:1760742480
Name:NOBLE, JACOB DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:DEAN
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 1:2005 8TH AVE E
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-1707
Mailing Address - Country:US
Mailing Address - Phone:218-263-8348
Mailing Address - Fax:
Practice Address - Street 1:2005 8TH AVE E
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-1707
Practice Address - Country:US
Practice Address - Phone:218-263-8348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND130681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice