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3700 Atherton Rd Rocklin CA 95765-3717 | |
(916) 626-4050 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 3700 Atherton Rd, Rocklin, California |
Authorized Official Name and Position | Shane Mark Douglas (PRESIDENT) |
Authorized Official Contact | 9166264050 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3700 Atherton Rd Rocklin CA 95765-3717 Ph: (916) 626-4050 | 3700 Atherton Rd Rocklin CA 95765-3717 Ph: (916) 626-4050 |
NPI Number | 1447591987 |
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Provider Enumeration Date | 03/08/2013 |
Last Update Date | 03/17/2021 |
Identifier | Type | State | Issuer |
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1447591987 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |
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