| Joly Jacob, D.m.d., P.c. | |
|
443 W Girard Ave Philadelphia PA 19123-1454 | |
| (215) 763-7985 | |
| (215) 763-7987 |
| Full Name | Joly Jacob, D.m.d., P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 443 W Girard Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Joly Jacob (OWNER / PRESIDENT) |
| Authorized Official Contact | 2157637985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joly Jacob, D.m.d., P.c. 443 W Girard Ave Philadelphia PA 19123-1454 Ph: (215) 763-7985 | Joly Jacob, D.m.d., P.c. 443 W Girard Ave Philadelphia PA 19123-1454 Ph: (215) 763-7985 |
| NPI Number | 1003088469 |
|---|---|
| Provider Enumeration Date | 03/26/2008 |
| Last Update Date | 03/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003088469 | NPI | - | NPPES |
| 01641673 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS030002L (Pennsylvania) | Primary |
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