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: CAPITOL DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 2682 Primary Status: Cancelled
Address :
2600 CAPITOL AVENUE #102
SACRAMENTO CA 95816
SACRAMENTO COUNTY



