Provider Demographics
NPI:1902064249
Name:SKOFF, JENNIFER MOLITOR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MOLITOR
Last Name:SKOFF
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 1:801 EDWIN LN
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1810
Mailing Address - Country:US
Mailing Address - Phone:201-572-3812
Mailing Address - Fax:
Practice Address - Street 1:6801 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2446
Practice Address - Country:US
Practice Address - Phone:215-677-0380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0371341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice