Organization
DOUGLAS R HALLORAN DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS RAY HALLORAN DDS (PRESIDENT)
(559) 224-9925
Entity
Organization
Contact information
Practice address
1100 W SHAW AVE, STE 146, FRESNO, CA 93711-3708
(559) 224-9925
(559) 224-4478
Mailing address
1100 W SHAW AVE, STE 146, FRESNO, CA 93711-3708
(559) 224-9925
(559) 224-4478
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
43532
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B43532 01
DENTI CAL
CA
Enumeration date
10/04/2005
Last updated
08/22/2020
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