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Organization

PAIN AND SLEEP THERAPY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARLY MARIE JACOBS DDS (CHIEF CLINICAL DIRECTOR)
(302) 299-5617
Entity
Organization

Contact information

Practice address
1149 W LANCASTER AVE SPC U-5, BRYN MAWR, PA 19010-2722
(302) 299-5617
Mailing address
620 CHURCHMANS RD STE 203, NEWARK, DE 19702-1945
(302) 299-5617

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary

Other

Enumeration date
03/21/2022
Last updated
03/21/2022
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