Dental Board of California
Licensing details for: 101918
Name: HENNE-BHULLAR, MISTY AUTUMN
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
1660 Willow St
Suite 7
SAN JOSE CA 95125-5101
SANTA CLARA county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHERRY FAMILY DENTAL DENTAL OFFICE OF MISTY HENNE-BHULLAR, DMD, INC
License/Registration Type: Fictitious Name Permit
License Number: 14383 Primary Status: Expired
Address :
4984 CHERRY AVE
SAN JOSE CA 95118
SANTA CLARA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: GREAT SMILES DENTAL, PRACTICE OF DRS. PANNU AND HENNE-BHULLAR
License/Registration Type: Fictitious Name Permit
License Number: 14083 Primary Status: Expired
Address :
3219 MCHENRY AVE STE E
MODESTO CA 95350
STANISLAUS 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: CHERRY FAMILY DENTAL DENTAL OFFICE OF MISTY HENNE-BHULLAR, DMD, INC
License/Registration Type: Fictitious Name Permit
License Number: 14383 Primary Status: Expired
Address :
4984 CHERRY AVE
SAN JOSE CA 95118
SANTA CLARA 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: GREAT SMILES DENTAL, PRACTICE OF DRS. PANNU AND HENNE-BHULLAR
License/Registration Type: Fictitious Name Permit
License Number: 14083 Primary Status: Expired
Address :
3219 MCHENRY AVE STE E
MODESTO CA 95350
STANISLAUS COUNTY
