# DOUGLAS R HALLORAN DDS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386631349
- **Authorized official:** DOUGLAS RAY HALLORAN DDS (PRESIDENT)
- **Authorized official phone:** (559) 224-9925

## Contact information

- **Practice address:** 1100 W SHAW AVE, STE 146, FRESNO, CA 93711-3708
- **Practice address phone:** (559) 224-9925
- **Practice address fax:** (559) 224-4478
- **Mailing address:** 1100 W SHAW AVE, STE 146, FRESNO, CA 93711-3708
- **Mailing address phone:** (559) 224-9925
- **Mailing address fax:** (559) 224-4478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 43532 | CA | Yes |

## Other

- **Enumeration date:** 10/04/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | B43532 01 | DENTI CAL | CA |