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Organization
JOLY JACOB, D.M.D., P.C.
Active
Organization
JOLY JACOB, D.M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOLY JACOB D.M.D. (OWNER / PRESIDENT)
(215) 763-7985
Entity
Organization
Contact information
Practice address
443 W GIRARD AVE, PHILADELPHIA, PA 19123-1454
(215) 763-7985
(215) 763-7987
Mailing address
443 W GIRARD AVE, PHILADELPHIA, PA 19123-1454
(215) 763-7985
(215) 763-7987
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS030002L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01641673
—
PA
Enumeration date
03/26/2008
Last updated
03/26/2008
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