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Organization
DOUGLAS AND KLOSS DENTAL
Active
Organization
DOUGLAS AND KLOSS DENTAL
Active
Other names
Heritage Oak Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE MARK DOUGLAS DDS (PRESIDENT)
(916) 626-4050
Entity
Organization
Contact information
Practice address
3700 ATHERTON RD, ROCKLIN, CA 95765-3717
(916) 626-4050
Mailing address
3700 ATHERTON RD, ROCKLIN, CA 95765-3717
(916) 626-4050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/08/2013
Last updated
03/17/2021
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