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General NPI Number Information
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NPI Number | 1083759070
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Entity Type | Organization
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Legal Business Name | G THOMAS NOAKES DDS
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 03/26/2008
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Provider Practice Location Address
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Address Line | 1121 NILES CORTLAND RD
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City | WARREN
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State | OH
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Zip | 44484
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Country | US
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Telephone | 330-856-5581
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Fax | 330-856-5894
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Provider Business Mailing Address
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Address Line | 1121 NILES CORTLAND RD
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City | WARREN
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State | OH
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Zip | 44484
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Country | US
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Telephone | 330-856-5581
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Fax | 330-856-5894
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Authorized Official
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Title or Position | DENTIST
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Name | GORDON THOMAS NOAKES
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Credential | DDS
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Telephone | 330-856-5581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30020366
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License Number State | OH
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