| Randall W Halliday Dds, Inc | |
|
245 Terracina Blvd Suite 211a Redlands CA 92373-4852 | |
| (909) 793-2629 | |
| (909) 798-2851 |
| Full Name | Randall W Halliday Dds, Inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 245 Terracina Blvd, Redlands, California |
| Authorized Official Name and Position | Randall W Halliday (PRESIDENT) |
| Authorized Official Contact | 9097932629 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randall W Halliday Dds, Inc 245 Terracina Blvd Suite 211a Redlands CA 92373-4852 Ph: (909) 793-2629 | Randall W Halliday Dds, Inc 245 Terracina Blvd Suite 211a Redlands CA 92373-4852 Ph: (909) 793-2629 |
| NPI Number | 1699082818 |
|---|---|
| Provider Enumeration Date | 09/09/2010 |
| Last Update Date | 09/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699082818 | NPI | - | NPPES |
| B22609 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 22609 (California) | Primary |
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