Organization
RANDALL W. HALLIDAY, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL HALLIDAY DDS (PRESIDENT)
(909) 886-6845
Entity
Organization
Contact information
Practice address
1697 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5112
(909) 886-6845
(909) 882-9804
Mailing address
1697 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5112
(909) 886-6845
(909) 882-9804
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
22609
CA
Other
Enumeration date
05/25/2007
Last updated
08/22/2020
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