Provider Demographics
NPI:1760685846
Name:NOBLE BABALMORADI, LORETTA (DMD)
Entity type:Individual
Prefix:
First Name:LORETTA
Middle Name:
Last Name:NOBLE BABALMORADI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 KRESGE WAY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-896-4976
Mailing Address - Fax:502-896-4977
Practice Address - Street 1:4001 KRESGE WAY
Practice Address - Street 2:SUITE 140
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-896-4976
Practice Address - Fax:502-896-4977
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6981122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist