# NOBLE ORAL SURGERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649039967
- **Authorized official:** JASON BRODY (CREDENTIALING MANAGER)
- **Authorized official phone:** (267) 494-1483

## Contact information

- **Practice address:** 817 OLD YORK RD STE 106, JENKINTOWN, PA 19046-1623
- **Practice address phone:** (267) 691-0011
- **Mailing address:** 211 GEIGER RD, PHILADELPHIA, PA 19115-1009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 03/18/2024
- **Last updated:** 01/24/2025