| NPI | 1407152705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P BLAZIC Owner 513-829-4111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: OH 30017039) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2011-02-03 |