Provider Demographics
NPI:1265873525
Name:JASPAN, JOEL (DDS)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:JASPAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2442
Mailing Address - Country:US
Mailing Address - Phone:610-277-5253
Mailing Address - Fax:610-277-5055
Practice Address - Street 1:832 GERMANTOWN PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2442
Practice Address - Country:US
Practice Address - Phone:610-277-5253
Practice Address - Fax:610-277-5055
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS16445L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics