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Licensing details for: 103277

Name: LAMANTIA, NICOLE RENEE

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

4347 NOBEL DRIVE
Unit 133
SAN DIEGO CA 92122
SAN DIEGO county
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Issuance Date

September 25, 2018

Expiration Date

November 30, 2026

Current Date / Time

June 7, 2025
8:33:47 AM

License Relationships

OCS to DDS, OMS, or SP

License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Related Party Role: Oral Conscious Sedation Certificate

Name: LAMANTIA, NICOLE RENEE

License/Registration Type: Oral Conscious Sedation Certificate

License Number: 3815 Primary Status: Cancelled

Address :
4347 Nobel Dr
Unit 133
SAN DIEGO CA 92122
SAN DIEGO COUNTY

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