Provider Demographics
NPI:1073767489
Name:BAUER, JOLENE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOLENE
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JOLENE
Other - Middle Name:
Other - Last Name:GREIPP BAUER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08501-0296
Mailing Address - Country:US
Mailing Address - Phone:609-208-0220
Mailing Address - Fax:609-208-0990
Practice Address - Street 1:10 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08501-1610
Practice Address - Country:US
Practice Address - Phone:609-208-0220
Practice Address - Fax:609-208-0990
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2019-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI020306001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice