Blazic, Randall J
Blazic, Randall J is an individual health care provider with primary practice located at 1646 N Litchfield Road Suite 130, Goodyear AZ 85338. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Blazic, Randall J can be contacted via phone (623) 935-5774.Contact Information
Primary practice address
1646 N Litchfield Road Suite 130
Goodyear AZ 85338
Phone: (623) 935-5774
Fax: (623) 935-6524
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | D5976 | Arizona |
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | M31657 | Arizona |
Profile Details
NPI number | 1497843445 |
---|---|
LBN Legal business name | Blazic, Randall J |
Credentials | DDS MD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 11th, 2006 |
Last updated | Jul 8th, 2007 - about 17 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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