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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 18 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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