Dental Board of California
Licensing details for: 103560
Name: KIM, MELANIE MIDORI
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
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: MELANIE KIM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80658 Primary Status: Current - Active
Address :
3381 BASS LAKE ROAD, SUITE 140
EL DORADO HILLS CA 95762
EL DORADO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF EL DORADO HILLS DENTAL GROUP, MELANIE KIM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15971 Primary Status: Current - Active
Address :
3381 BASS LAKE ROAD, SUITE 140
EL DORADO HILLS CA 95762
EL DORADO 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 EL DORADO HILLS DENTAL GROUP, MELANIE KIM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15971 Primary Status: Current - Active
Address :
3381 BASS LAKE ROAD, SUITE 140
EL DORADO HILLS CA 95762
EL DORADO COUNTY
