NPI 1689886657

Palm Valley Oral Surgery

Organisation Oral & Maxillofacial Surgery (D.M.D.) Goodyear, AZ

Practice location

Address: 1646 N Litchfield Road STE 130, Goodyear, AZ 85338
Phone: (623) 935-5774
Fax: (623) 935-6524

Authorised official

Name: Randall J Blazic
Title: Owner
Phone: (623) 935-5774

Registered specialties

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence M31657 (AZ)

Other Oral & Maxillofacial Surgery providers in Arizona →

Registry record

NPI: 1689886657
Entity type: Organization
NPI issued: 4 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.