Individual
CARLY JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1149 W LANCASTER AVE STE 5, BRYN MAWR, PA 19010-2722
(610) 851-4299
Mailing address
1149 W LANCASTER AVE STE 5, BRYN MAWR, PA 19010-2722
(610) 851-4299
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041967
PA
Other
Enumeration date
03/04/2016
Last updated
01/24/2023
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