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General NPI Number Information
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NPI Number | 1427492834
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Entity Type | Organization
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Legal Business Name | RANDALL T CALIFF DDS PA
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 04/29/2013
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Provider Practice Location Address
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Address Line | 12578 W SUNRISE BLVD
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City | SUNRISE
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State | FL
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Zip | 33323
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Country | US
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Telephone | 954-851-9829
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Fax | 954-851-0822
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Provider Business Mailing Address
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Address Line | 2740 LAKE WAY
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City | HOLLYWOOD
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State | FL
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Zip | 33026-3686
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Country | US
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Telephone | 954-432-1841
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Fax | 954-430-1622
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Authorized Official
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Title or Position | OWNER
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Name | RANDALL TODD CALIFF
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Credential | DDS
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Telephone | 954-432-1841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN9027
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License Number State | FL
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