Dental Board of California
Licensing details for: 38465
Name: TAKLA, PAUL MICHAEL
License Type: Dentist
Primary Status: Current - Active
Address of Record
2130 RALSTON AVE STE 1E
BELMONT CA 94002
SAN MATEO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: EVERGREEN DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 1337 Primary Status: Cancelled
Address :
MICHAEL T. VEHAWN
3162 NEWBERRY DRIVE
SAN JOSE CA 95118
SANTA CLARA 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: EVERGREEN DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 1337 Primary Status: Cancelled
Address :
MICHAEL T. VEHAWN
3162 NEWBERRY DRIVE
SAN JOSE CA 95118
SANTA CLARA COUNTY
