Individual
DR. JOLY JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
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
—
0164167305
—
PA
Enumeration date
02/16/2007
Last updated
07/08/2007
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