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Jacob R Carroll, DMD
Oral and Maxillofacial Surgery (Dentist) in Glendale, Arizona
NPI 1205192663

Jacob R Carroll is a Oral and Maxillofacial Surgery (Dentist) based in Glendale, AZ and is specialized in Oral and Maxillofacial Surgery. Jacob R Carroll practices in Glendale, AZ and has the professional credentials of DMD. The NPI Number for Jacob R Carroll is 1205192663 and holds a License No. (Arizona).

The current practice location address for Jacob R Carroll is 20100 N 51St Ave, Glendale, AZ and can be reached out via phone at 623-572-4300.

Location: 20100 N 51St Ave, Glendale, AZ, 85308-5125
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205192663
Provider Name
Jacob R Carroll
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
20100 N 51St Ave, Glendale, AZ, 85308-5125
Phone Number
623-572-4300
Fax Number
Provider Enumeration Date
04/10/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
20100 N 51St Ave
City
Glendale
State
Arizona
Zip
85308-5125
Phone Number
623-572-4300
Fax Number
person
Provider Business Mailing Address Details
Address
20100 N 51St Ave
City
Glendale
State
Arizona
Zip
85308-5125
Phone Number
623-572-4300
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
D9440 (Arizona)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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