| NPI | 1932488681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL W HALLIDAY President 909-886-6845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 22609) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |