Provider Demographics
NPI:1780642132
Name:SABOL, JON GREGORY (DDS,MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:GREGORY
Last Name:SABOL
Suffix:
Gender:M
Credentials:DDS,MD
Other - Prefix:
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Mailing Address - Street 1:5050 N. 40TH STREET, #180
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018
Mailing Address - Country:US
Mailing Address - Phone:602-957-0332
Mailing Address - Fax:602-957-3282
Practice Address - Street 1:5050 N. 40TH STREET, #180
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018
Practice Address - Country:US
Practice Address - Phone:602-957-0332
Practice Address - Fax:602-957-3282
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ68161223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery