Provider Demographics
NPI:1952724858
Name:NOGGLE, REBECCA (RDH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NOGGLE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 STATE ROUTE 309
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833
Mailing Address - Country:US
Mailing Address - Phone:419-571-5958
Mailing Address - Fax:
Practice Address - Street 1:1001 OLIVESBURG RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905-1228
Practice Address - Country:US
Practice Address - Phone:419-526-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31010972124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist