Organization
RANDALL W HALLIDAY DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL W 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
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22609
CA
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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