Provider Demographics
NPI:1407992852
Name:JOLLEY, NANCY J (DMD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:J
Last Name:JOLLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2761 TRENTON RD.
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19056-1430
Mailing Address - Country:US
Mailing Address - Phone:215-943-7757
Mailing Address - Fax:215-943-8948
Practice Address - Street 1:2761 TRENTON RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-1430
Practice Address - Country:US
Practice Address - Phone:215-943-7757
Practice Address - Fax:215-943-8948
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-026219L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice