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Organization

USAF

Active
Other names
Wilford Hall Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RANDALL JUDSON MCDANIEL DMD (DIRECTOR OF OROFACIAL PAIN)
(210) 292-6393
Entity
Organization

Contact information

Practice address
2200 BERQUIST DRIVE, SUITE 1, LACKLAND AFB, TX 78236-5300
(210) 292-6393
(210) 292-3338
Mailing address
2200 BERQUIST DRIVE, SUITE 1, LACKLAND AFB, TX 78236-5300
(210) 292-6393
(210) 292-3338

Taxonomy

Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
5934-015
WI

Other

Enumeration date
01/09/2006
Last updated
08/22/2020
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