Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RANDALL J BLAZIC, DDS MD
ActiveRANDALL J BLAZIC, DDS MD is a Oral & Maxillofacial Surgery healthcare provider located in GOODYEAR, Arizona. NPI 1497843445 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · GOODYEAR, AZ
Registration Details
- NPI Number
- 1497843445
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 11, 2006 (19.798898452433 yrs)
- Last Updated
- Apr 22, 2025
- Licenses
-
M31657 (AZ)D5976 (AZ)
Practice Information
- Address
-
13980 W AVALON DR STE 120GOODYEAR, AZ, 853951404Browse AZ providers · Browse ZIP 85395
- Phone
- 6239355774
- Fax
- 6239356524
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.