DR. Shane Mark Douglas, D.D.S.

NPI #1902169774 in Rocklin, California

Provider Information

NPI Number
1902169774
Entity Type
Individual
Name
DR. Shane Mark Douglas, D.D.S.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dentist
Credential
D.D.S.
Enumeration Date
Jun 18, 2012
Last Updated
Dec 2, 2013

Practice Location

Address
3700 ATHERTON RD
ZIP Code
95765-3717
Phone
(916) 626-4050

Specialties & Taxonomy Codes

Specialty
Dentist

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