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Organization
JOHN P BLAZIC DDS INC
Active
Organization
JOHN P BLAZIC DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN P BLAZIC DDS (OWNER)
(513) 829-4111
Entity
Organization
Contact information
Practice address
1251 NILLES ROAD, SUITE 12, FAIRFIELD, OH 45014-7205
(513) 829-4111
(513) 829-5140
Mailing address
1251 NILLES ROAD, SUITE 12, FAIRFIELD, OH 45014-7205
(513) 829-4111
(513) 829-5140
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30017039
OH
Other
Enumeration date
02/03/2011
Last updated
02/03/2011
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