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1902169774
SHANE MARK DOUGLAS
ROCKLIN, CA
NPI
1902169774
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: CA 61439)
Enumeration Date
2012-06-18
Last Update Date
2013-12-02
Business Address
Dr. SHANE MARK DOUGLAS D.D.S.
3700 ATHERTON RD
ROCKLIN, CA 95765-3717
Phone number: 916-626-4050
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Mailing Address
Dr. SHANE MARK DOUGLAS D.D.S.
3700 ATHERTON RD
ROCKLIN, CA 95765-3717
Phone number: 916-626-4050
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