Dental Board of California
Licensing details for: 102798
Name: MAK, RYAN
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
4625 2nd St
Suite 100
DAVIS CA 95618-9417
YOLO county
Map
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: VICUNA AND MAK DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80894 Primary Status: Current - Active
Address :
4515 FERMI PLACE, SUITE 106
DAVIS CA 95618
YOLO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DAVIS SMILES DENTISTRY DENTAL GROUP, VICUNA AND MAK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16475 Primary Status: Current - Active
Address :
4515 FERMI PLACE SUITE 106
DAVIS CA 95618
YOLO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF DAVIS DENTAL GROUP, MAK AND VICUNA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18624 Primary Status: Current - Active
Address :
4625 SECOND STREET, SUITE 100
DAVIS CA 95618
YOLO 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: DAVIS SMILES DENTISTRY DENTAL GROUP, VICUNA AND MAK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16475 Primary Status: Current - Active
Address :
4515 FERMI PLACE SUITE 106
DAVIS CA 95618
YOLO 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: DENTISTS OF DAVIS DENTAL GROUP, MAK AND VICUNA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18624 Primary Status: Current - Active
Address :
4625 SECOND STREET, SUITE 100
DAVIS CA 95618
YOLO COUNTY
