Dental Board of California
Licensing details for: 34614
Name: GRECCO, MARK ADRIAN
License Type: Dentist
Primary Status: Current - Active
Previous Names: GRECCO, MARK A
Address of Record
1511 WEST YOSEMITE
MANTECA CA 95337
SAN JOAQUIN 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: R. CICCARELLI, DDS., R. JOSEPH, DDS., M. EI FARRA, DDS., D. SAINI, DDS., INC.
License/Registration Type: Additional Office Permit
License Number: 79075 Primary Status: Expired
Address :
1511 W Yosemite Ave
MANTECA CA 95337-5159
SAN JOAQUIN 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: M HOCHHALTER, DDS, B MOREHEAD, DDS, M BLEDSOE, DDS, INC
License/Registration Type: Additional Office Permit
License Number: 8173 Primary Status: Cancelled
Address :
1511 WEST YOSEMITE
MANTECA CA 95337
SAN JOAQUIN COUNTY
FCS to DDS
License/Registration Role: Must hold an active Dental License
Related Party Role: Elective Facial Cosmetic Surgery Permit
Name: GRECCO, MARK ADRIAN
License/Registration Type: Elective Facial Cosmetic Surgery Permit
License Number: 16 Primary Status: Current - Active
Address :
1511 W Yosemite Ave
MANTECA CA 95337-5159
SAN JOAQUIN 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: VALLEY OAK DENTAL GROUP, R. CICCARELLI, DDS., R. JOSEPH, DDS., M.
License/Registration Type: Fictitious Name Permit
License Number: 9158 Primary Status: Current - Active
Address :
1507 W YOSEMITE AVENUE
MANTECA CA 95337
SAN JOAQUIN COUNTY
GA to DDS or OMS or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: General Anesthesia Permit
Name: TESSLER, KENNETH
License/Registration Type: General Anesthesia Permit
License Number: 865 Primary Status: Cancelled
Address :
450 SUTTER STREET
C/O SUTTER STREET SURGERY CNTR 6 FLOOR
SAN FRANCISCO CA 94108
SAN FRANCISCO COUNTY
GA to DDS or OMS or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: General Anesthesia Permit
Name: GRECCO, MARK ADRIAN
License/Registration Type: General Anesthesia Permit
License Number: 964 Primary Status: Current - Active
Address :
1511 WEST YOSEMITE
MANTECA CA 95337
SAN JOAQUIN COUNTY
