| NPI | 1699082818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL W HALLIDAY President 909-793-2629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 22609) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2010-09-09 |