| John P Blazic Dds Inc | |
|
1251 Nilles Road Suite 12 Fairfield OH 45014-7205 | |
| (513) 829-4111 | |
| (513) 829-5140 |
| Full Name | John P Blazic Dds Inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1251 Nilles Road, Fairfield, Ohio |
| Authorized Official Name and Position | John P Blazic (OWNER) |
| Authorized Official Contact | 5138294111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John P Blazic Dds Inc 1251 Nilles Road Suite 12 Fairfield OH 45014-7205 Ph: (513) 829-4111 | John P Blazic Dds Inc 1251 Nilles Road Suite 12 Fairfield OH 45014-7205 Ph: (513) 829-4111 |
| NPI Number | 1407152705 |
|---|---|
| Provider Enumeration Date | 02/03/2011 |
| Last Update Date | 02/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407152705 | NPI | - | NPPES |
| 0496584 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 30017039 (Ohio) | Primary |
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