Organization
ORAL & FACIAL SURGEONS OF ARIZONA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON GREGORY SABOL D.M.D., M.D. (OWNER)
(602) 957-0332
Entity
Organization
Contact information
Practice address
5050 N. 40TH STREET, SUITE 180, PHOENIX, AZ 85018
(602) 957-0332
(602) 957-3282
Mailing address
5050 N. 40TH STREET, SUITE 180, PHOENIX, AZ 85018
(602) 957-0332
(602) 957-3282
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6147
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6816
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083717
—
AZ
05
—
089805
—
AZ
05
—
931920
—
AZ
Enumeration date
06/15/2007
Last updated
12/28/2017
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