Provider Demographics
NPI:1821386756
Name:NOBLE, ANDREW MAX (DDS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MAX
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 1:504 S LYNN RIGGS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-7814
Mailing Address - Country:US
Mailing Address - Phone:918-283-7377
Mailing Address - Fax:918-203-0718
Practice Address - Street 1:504 S LYNN RIGGS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-7814
Practice Address - Country:US
Practice Address - Phone:918-283-7377
Practice Address - Fax:918-203-0718
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8029303-99221223G0001X
WADE 603426621223G0001X
AZD0104441223G0001X
OK76491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice