| Noble Dental Office | |
|
590 E Foothill Blvd Azusa CA 91702-2542 | |
| (626) 969-1116 | |
| (626) 969-0737 |
| Full Name | Noble Dental Office |
|---|---|
| Speciality | Dentist |
| Location | 590 E Foothill Blvd, Azusa, California |
| Authorized Official Name and Position | Prakash Amratlal Katbamna (PRESIDENT) |
| Authorized Official Contact | 6269691116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Noble Dental Office 590 E Foothill Blvd Azusa CA 91702-2542 Ph: (626) 969-1116 | Noble Dental Office 590 E Foothill Blvd Azusa CA 91702-2542 Ph: (626) 969-1116 |
| NPI Number | 1356471320 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 10/03/2013 |
| Medicare PECOS PAC ID | 3870724826 |
|---|---|
| Medicare Enrollment ID | O20140317000466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356471320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 49557 (California) | Primary |
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