Dental Board of California
Licensing details for: 28517
Name: BENNETT, TIMOTHY PAUL
License Type: Dentist
Primary Status: Current - Active
Address of Record
P.O. Box 593
ROSEVILLE CA 95661-9998
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: TIMOTHY BENNETT DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79212 Primary Status: Current - Active
Address :
8008 Walerga Rd Ste 100
ANTELOPE CA 95843-9003
SACRAMENTO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: WALERGA DENTAL GROUP TIMOTHY BENNETT DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14114 Primary Status: Current - Active
Address :
8008 WALEGRA ROAD, SUITE 100
ANTELOPE CA 95843
SACRAMENTO 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: WALERGA DENTAL GROUP TIMOTHY BENNETT DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14114 Primary Status: Current - Active
Address :
8008 WALEGRA ROAD, SUITE 100
ANTELOPE CA 95843
SACRAMENTO COUNTY
