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Individual

DR. HENRY L. JOLLY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D., P.C.

Contact information

Practice address
914 S LIMESTONE ST, GAFFNEY, SC 29340-2126
(864) 489-2221
(864) 489-2171
Mailing address
914 S LIMESTONE ST, GAFFNEY, SC 29340-2126
(864) 489-2221
(864) 489-2171

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3370
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
571119518
FEDERAL TAX ID #
SC
Enumeration date
06/23/2006
Last updated
09/08/2008
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