Provider Demographics
NPI:1740088871
Name:JOLIVET, KAYLA MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:MARIE
Last Name:JOLIVET
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 SAINT LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-2256
Mailing Address - Country:US
Mailing Address - Phone:610-779-6990
Mailing Address - Fax:
Practice Address - Street 1:2951 SAINT LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2256
Practice Address - Country:US
Practice Address - Phone:610-779-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044981122300000X
NJ22DI02963900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist