Dental Board of California
Licensing details for: 100687
Name: POLUMBO, TIMOTHY C
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by Residency
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: POLUMBO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79690 Primary Status: Cancelled
Address :
3291 STANFORD RANCH ROAD, STE 102
ROCKLIN CA 95765
PLACER COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: HIGHLAND DENTAL GROUP, POLUMBO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14250 Primary Status: Cancelled
Address :
3291 STANFORD RANCH RD STE 102
ROCKLIN CA 95765
PLACER COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: YUBA CITY SMILES DENTAL OFFICE OF DR TIMOTHY C. POLUMBO
License/Registration Type: Fictitious Name Permit
License Number: 17097 Primary Status: Current - Active
Address :
415 ALTURAS ST. SUITE 1
YUBA CITY CA 95991
SUTTER COUNTY
FNP to DDS or OMS
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Fictitious Name Permit
Name: HIGHLAND DENTAL GROUP, POLUMBO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14250 Primary Status: Cancelled
Address :
3291 STANFORD RANCH RD STE 102
ROCKLIN CA 95765
PLACER COUNTY
FNP to DDS or OMS
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Fictitious Name Permit
Name: YUBA CITY SMILES DENTAL OFFICE OF DR TIMOTHY C. POLUMBO
License/Registration Type: Fictitious Name Permit
License Number: 17097 Primary Status: Current - Active
Address :
415 ALTURAS ST. SUITE 1
YUBA CITY CA 95991
SUTTER COUNTY
