Dental Board of California
Licensing details for: 42214
Name: PUCCINELLI, LAWRENCE ANDREW JR
License Type: Dentist
Primary Status: Current - Active
Previous Names: PUCCINELLI, LAWRENCE ANDREW
Address of Record
15075 Los Gatos Blvd Ste 120
LOS GATOS CA 95032-2049
SANTA CLARA county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CUPERTINO ENDODONTIC DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 3276 Primary Status: Cancelled
Address :
10363 TORRE AVE STE E
CUPERTINO CA 95014
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: CUPERTINO ENDODONTIC DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 3276 Primary Status: Cancelled
Address :
10363 TORRE AVE STE E
CUPERTINO CA 95014
SANTA CLARA COUNTY
