Provider Demographics
NPI:1265434161
Name:NOBLE, LLOYD KENNETH JR (DDS)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:KENNETH
Last Name:NOBLE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:KENNETH
Other - Middle Name:
Other - Last Name:NOBLE
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:12324 S WESTERN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5916
Mailing Address - Country:US
Mailing Address - Phone:405-703-2248
Mailing Address - Fax:405-703-2248
Practice Address - Street 1:12324 S WESTERN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5916
Practice Address - Country:US
Practice Address - Phone:405-703-2248
Practice Address - Fax:405-703-2248
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK44851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice