Provider Demographics
NPI:1902814429
Name:SUSAN J. NOBLE, D.D.S., P.C.
Entity Type:Organization
Organization Name:SUSAN J. NOBLE, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-535-5330
Mailing Address - Street 1:PO BOX 559
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-0559
Mailing Address - Country:US
Mailing Address - Phone:410-535-5330
Mailing Address - Fax:410-535-5544
Practice Address - Street 1:540 MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3346
Practice Address - Country:US
Practice Address - Phone:410-535-5330
Practice Address - Fax:410-535-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty