Dental Board of California
Licensing details for: 110711
Name: TABA, TALIA
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by ADEX
Address of Record
2200 Oak Grove Rd
WALNUT CREEK CA 94598-2509
CONTRA COSTA county
Map
License Relationships
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: Walnut Creek Modern Dentistry, Dental Group of Walnut Creek Modern Dentistry, Prof. Corp.
License/Registration Type: Fictitious Name Permit
License Number: 20733 Primary Status: Current - Active
Address :
2200 Oak Grove Road
WALNUT CREEK CA 94598
CONTRA COSTA COUNTY
