Carroll, Jacob R

Carroll, Jacob R is an sole proprietor health care provider with primary practice located at 20100 N 51St Ave Suite C-310, Glendale AZ 85308-5125. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Carroll, Jacob R can be contacted via phone (623) 572-4300.

Contact Information

Primary practice address
20100 N 51St Ave Suite C-310 Glendale AZ 85308-5125
Phone: (623) 572-4300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X D9440 Arizona

Profile Details

NPI number 1205192663
LBN Legal business name Carroll, Jacob R
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 10th, 2012
Last updated Sep 26th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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