Bryan R Blazer DDS PC

NPI #1578009577 in Elgin, Illinois

Provider Information

NPI Number: 1578009577
Entity Type: Organization
Organization Name: Bryan R Blazer DDS PC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jan 13, 2017
Last Updated: Jan 13, 2017

Practice Location

Address: 431 SUMMIT ST STE 105
City: Elgin
State: Illinois
ZIP Code: 60120-3861
Phone: (847) 742-6717

Authorized Official

Name: DR. BRYAN R BLAZER, DDS
Title: PRESIDENT/OWNER
Phone: (847) 742-6717

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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