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: USHA MANTENA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 78991 Primary Status: Current - Active
Address :
671 Elmira Rd
Suite 130
VACAVILLE CA 95687-4655
SOLANO 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: NUT TREE SMILES DENTISTRY AND ORTHODONTICS, DENTAL GROUP OF MANTE
License/Registration Type: Fictitious Name Permit
License Number: 10733 Primary Status: Cancelled
Address :
110 NUT TREE PARKWAY
VACAVILLE CA 95687
SOLANO 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: VACAVILLE DENTISTRY DENTAL GROUP, USHA MANTENA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13900 Primary Status: Current - Active
Address :
671 ELMIRA ROAD, SUITE 130
VACAVILLE CA 95687
SOLANO COUNTY
