# RANDALL W HALLIDAY DDS INC

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

## Provider details

- **NPI number:** 1932488681
- **Authorized official:** RANDALL W HALLIDAY DDS (PRESIDENT)
- **Authorized official phone:** (909) 886-6845

## Contact information

- **Practice address:** 1697 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5112
- **Practice address phone:** (909) 886-6845
- **Practice address fax:** (909) 882-9804
- **Mailing address:** 1697 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5112
- **Mailing address phone:** (909) 886-6845
- **Mailing address fax:** (909) 882-9804

## Taxonomy

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

## Other

- **Enumeration date:** 08/12/2011
- **Last updated:** 08/12/2011