Dental Board of California
Licensing details for: 103963
Name: KHATTAK, HARRIS KHAN
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
4184 Molten Creek Way
ROSEVILLE CA 95747-4556
PLACER 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: KHATTAK DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81440 Primary Status: Current - Active
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER COUNTY
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: HARRIS KHATTAK, DDS
License/Registration Type: Additional Office Permit
License Number: 82734 Primary Status: Current - Active
Address :
995 Tharp Road, Suite B
YUBA CITY CA 95993
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: PARKWAY DENTAL GROUP, KHATTAK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17666 Primary Status: Current - Active
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
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: Yuba City Modern Dentistry, Dental Group of Yuba City Modern Dentistry, Inc.
License/Registration Type: Fictitious Name Permit
License Number: 20174 Primary Status: Current - Active
Address :
995 Tharp Rd, Ste B
YUBA CITY CA 95993
