Individual provider · Type 1 NPI

Jacob R. Carroll, DMD

Oral and Maxillofacial Surgery (Dentist) · Glendale, AZ

NPI number 1205192663 Active

Practice location

20100 N 51st Ave, Suite C-310
Glendale, AZ 85308-5125

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112XD9440 (AZ)

Oral and Maxillofacial Surgery (Dentist): 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.

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About NPI 1205192663

Jacob R. Carroll, DMD's National Provider Identifier is 1205192663, issued on Apr 10, 2012. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Glendale, AZ. The record was last updated on Sep 26, 2016.