Individual provider · Type 1 NPI
Randall J. Blazic, DDS MD
Oral and Maxillofacial Surgery (Dentist) · Goodyear, AZ
NPI number
1497843445
Active
Practice location
13980 W Avalon Dr Ste 120
Goodyear, AZ 85395-1404
Fax (623) 935-6524
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | M31657 (AZ) |
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | D5976 (AZ) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Other oral and maxillofacial surgery (dentist) providers in Goodyear
About NPI 1497843445
Randall J. Blazic, DDS MD's National Provider Identifier is 1497843445, issued on Oct 11, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Goodyear, AZ. The record was last updated on Apr 22, 2025.