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General NPI Number Information
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NPI Number | 1881904795
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Entity Type | Organization
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Legal Business Name | NOBLE ORTHODONTICS
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 2402 COLLEGE HILLS BLVD
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City | SAN ANGELO
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State | TX
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Zip | 76904
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Country | US
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Telephone | 325-949-2824
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Fax | 325-949-0383
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Provider Business Mailing Address
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Address Line | 2402 COLLEGE HILLS BLVD
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City | SAN ANGELO
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State | TX
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Zip | 76904
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Country | US
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Telephone | 325-949-2824
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Fax | 325-949-0383
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Authorized Official
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Title or Position | PARTNER
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Name | DR. DAVID RICHARD RIES
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Credential |
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Telephone | 325-949-2824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 25697
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License Number State | TX
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