Dental Board of California
Licensing details for: 101166
Name: GONZALEZ, CUAUHTEMOC AZTLAN
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PLACER SMILES PEDIATRIC DENTISTRY DENTAL PRACTICE OF CA GONZALEZ DENTAL CORP
License/Registration Type: Fictitious Name Permit
License Number: 18150 Primary Status: Current - Active
Address :
620 TWELVE BRIDGES DRIVE, SUITE 120
LINCOLN CA 95648-8866
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: PLACER SMILES PEDIATRIC DENTISTRY DENTAL PRACTICE OF CA GONZALEZ DENTAL CORP
License/Registration Type: Fictitious Name Permit
License Number: 18150 Primary Status: Current - Active
Address :
620 TWELVE BRIDGES DRIVE, SUITE 120
LINCOLN CA 95648-8866
PLACER COUNTY
