DR. Bryan Blazer, D.D.S.

NPI #1851677850 in Joint Base Langley-Eustis, Virginia

Provider Information

NPI Number: 1851677850
Entity Type: Individual
Name: DR. Bryan Blazer, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Oct 24, 2011
Last Updated: Oct 24, 2011

Practice Location

Address: 77 NEALY AVE
Address 2: 633D MEDICAL GROUP
City: Joint Base Langley-Eustis
State: Virginia
ZIP Code: 23665-2040
Phone: (764) 225-5039

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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