Provider Demographics
NPI:1124244470
Name:CALIFF, RANDALL T (DDS,PA)
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:T
Last Name:CALIFF
Suffix:
Gender:M
Credentials:DDS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3686
Mailing Address - Country:US
Mailing Address - Phone:954-432-1841
Mailing Address - Fax:954-430-1622
Practice Address - Street 1:6890 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6000
Practice Address - Country:US
Practice Address - Phone:954-987-4435
Practice Address - Fax:954-987-4460
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL90271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice