| Shah Jolly Dds Dental Corporation | |
|
1761 E Capitol Expy San Jose CA 95121-1561 | |
| (408) 223-2500 | |
| (408) 223-5525 |
| Full Name | Shah Jolly Dds Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1761 E Capitol Expy, San Jose, California |
| Authorized Official Name and Position | Jolly Shah (PRESIDENT/DENTIST) |
| Authorized Official Contact | 4082232500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shah Jolly Dds Dental Corporation 44240 Revere Pl Fremont CA 94539-5902 Ph: (510) 520-0136 | Shah Jolly Dds Dental Corporation 1761 E Capitol Expy San Jose CA 95121-1561 Ph: (408) 223-2500 |
| NPI Number | 1841722337 |
|---|---|
| Provider Enumeration Date | 04/03/2017 |
| Last Update Date | 10/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841722337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 44775 (California) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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