MEDICARE: JOLIE DENTAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	21384	TX

General Provider Information

NPI Number	:	1861598666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOLIE DENTAL

Provider Business Mailing Address
First Line	:	10311 N ELDRIDGE PKWY
Second Line	:	SUITE B-7
City	:	HOUSTON
State	:	TX
Zip	:	77065-5368
Country	:	US
Telephone Number	:	281-897-9977
Fax Number	:	281-897-9982

Provider Business Practice Location Address
First Line	:	10311 N ELDRIDGE PKWY
Second Line	:	SUITE B-7
City	:	HOUSTON
State	:	TX
Zip	:	77065-5368
Country	:	US
Telephone Number	:	281-897-9977
Fax Number	:	281-897-9982

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. JOLIE CHU
Credential	:	D.D.S.
Telephone Number	:	281-897-9977

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/22/2020

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Directions to “JOLIE DENTAL ” Practice Location

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