# RANDALL W HALLIDAY DDS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699082818
- **Authorized official:** DR. RANDALL W HALLIDAY DDS (PRESIDENT)
- **Authorized official phone:** (909) 793-2629

## Contact information

- **Practice address:** 245 TERRACINA BLVD, SUITE 211A, REDLANDS, CA 92373-4852
- **Practice address phone:** (909) 793-2629
- **Practice address fax:** (909) 798-2851
- **Mailing address:** 245 TERRACINA BLVD, SUITE 211A, REDLANDS, CA 92373-4852
- **Mailing address phone:** (909) 793-2629
- **Mailing address fax:** (909) 798-2851

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 22609 | CA | Yes |

## Other

- **Enumeration date:** 09/09/2010
- **Last updated:** 09/09/2010