| NPI | 1457562993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL HALLIDAY President 909-886-6845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CA 22609) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-08-22 |