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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