Dental Board of California
Licensing details for: 54297
Name: PATEL, DHAVAL RAMAN
License Type: Dentist
Primary Status: Current - Active
Address of Record
10357 Fairway Dr
Ste 100
ROSEVILLE CA 95678-3544
PLACER 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: KHALED ENTABI DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80859 Primary Status: Expired
Address :
3746 FALLON ROAD
DUBLIN CA 94568
ALAMEDA 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: Alubaidi Dental Corporation
License/Registration Type: Additional Office Permit
License Number: 81391 Primary Status: Current - Active
Address :
2380 MONUMENT BLVD., SUITE F
PLEASANT HILL CA 94523
CONTRA COSTA 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: KHALED ENTABI DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81342 Primary Status: Expired
Address :
3746 FALLON ROAD
DUBLIN CA 94568
ALAMEDA 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: RUCHI ARORA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81336 Primary Status: Cancelled
Address :
2405 IRON POINT ROAD., SUITE 100
FOLSOM CA 95630
SACRAMENTO 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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82268 Primary Status: Current - Active
Address :
8472 N. Friant Road
FRESNO CA 93720
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82428 Primary Status: Current - Active
Address :
10842 Bear Hollow Drive Suite 101
RANCHO CORDOVA CA 95670
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82515 Primary Status: Current - Active
Address :
3290 Arena Blvd. Suite 610
SACRAMENTO CA 95834
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82454 Primary Status: Current - Active
Address :
4515 Fermi Pl., Suite 106
DAVIS CA 95618
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: PATEL AND GILL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 11693 Primary Status: Current - Active
Address :
6315 COMMERCE BLVD
ROHNERT PARK CA 94928
SONOMA 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: GILL AND LOPEZ PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80358 Primary Status: Cancelled
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER 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: PARULEKAR DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81529 Primary Status: Current - Active
Address :
3746 Fallon Road
DUBLIN CA 94568
ALAMEDA 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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82323 Primary Status: Current - Active
Address :
1008 W Shaw Ave., Ste 105
FRESNO CA 93711
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82477 Primary Status: Current - Active
Address :
9630 Bruceville Rd., Suite 102
ELK GROVE CA 95757
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82240 Primary Status: Current - Active
Address :
5315 Sunrise Blvd.
FAIR OAKS CA 95628
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82476 Primary Status: Current - Active
Address :
241 W. E Ave, Ste 1
CHICO CA 95926
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82459 Primary Status: Current - Active
Address :
948 Diablo Ave
NOVATO CA 94947
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: HOANG AND RHO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79397 Primary Status: Cancelled
Address :
4690 NATOMAS BLVD STE 100
SACRAMENTO CA 95835
SACRAMENTO 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: TIMOTHY BENNETT DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79212 Primary Status: Current - Active
Address :
8008 Walerga Rd Ste 100
ANTELOPE CA 95843-9003
SACRAMENTO 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: FAREID DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79273 Primary Status: Cancelled
Address :
4129 S MOONEY BLVD SUITE B
VISALIA CA 93277
TULARE 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: AMARDEEP GILL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79874 Primary Status: Cancelled
Address :
2041 BRONZE STAR DR STE 100
WOODLAND CA 95776
YOLO 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: DHAVAL PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79267 Primary Status: Expired
Address :
3000 DANVILLE BLVD STE A
ALAMO CA 94507
CONTRA COSTA 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: GHAZAL, FAREID AND SOOD DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81163 Primary Status: Cancelled
Address :
1008 W. SHAW AVENUE, SUITE 105
FRESNO CA 93711
FRESNO 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: SINGH AND PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81153 Primary Status: Current - Active
Address :
3000 DANVILLE BLVD. SUITE A
ALAMO CA 94507
CONTRA COSTA 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: VICUNA AND MAK DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80894 Primary Status: Current - Active
Address :
4515 FERMI PLACE, SUITE 106
DAVIS CA 95618
YOLO 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: BEVAN S. FAREID, D.D.S., INC.
License/Registration Type: Additional Office Permit
License Number: 81194 Primary Status: Current - Active
Address :
827 AKERS STREET., SUITE 104
VISALIA CA 93277
TULARE 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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82288 Primary Status: Current - Active
Address :
775 Ikea Court Suite 130
WEST SACRAMENTO CA 95605
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82182 Primary Status: Current - Active
Address :
8204 DELTA SHORES CIR. S. SUITE 140
SACRAMENTO CA 95832
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82469 Primary Status: Current - Active
Address :
2405 Iron Point Rd., Suite 100
FOLSOM CA 95630
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82061 Primary Status: Current - Active
Address :
2682 NAGLEE RD., SUITE 110
TRACY CA 95304
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: GILL AND PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79852 Primary Status: Cancelled
Address :
2610 REYNOLDS RANCH PKWY STE 100
LODI CA 95240
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: BAUTISTA AND GILL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81154 Primary Status: Cancelled
Address :
2455 JEFFERSON BLVD. SUITE 130
WEST SACRAMENTO CA 95691
YOLO 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: BAUTISTA AND PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81146 Primary Status: Cancelled
Address :
370 CODDINGTOWN CENTER
SANTA ROSA CA 95401
SONOMA 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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82201 Primary Status: Current - Active
Address :
2610 REYNOLDS RANCH PKWY. SUITE 100
LODI CA 95240
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82502 Primary Status: Current - Active
Address :
9640 Bruceville Rd., Suite 101
ELK GROVE CA 95757
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82492 Primary Status: Current - Active
Address :
10910 Olson Dr, Ste 100
RANCHO CORDOVA CA 95670
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82425 Primary Status: Current - Active
Address :
370 Coddingtown Center
SANTA ROSA CA 95401
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82522 Primary Status: Current - Active
Address :
10064 Bruceville Road Suite 140
ELK GROVE CA 95757
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82504 Primary Status: Current - Active
Address :
1990 Blue Oaks Blvd., Ste. 100
ROSEVILLE CA 95747
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: GHAZAL, GILL AND PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 11687 Primary Status: Cancelled
Address :
4129 S MOONEY BLVD
SUITE B
VISALIA CA 93277
TULARE 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: KESHTKAR DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79367 Primary Status: Expired
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER 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: AMARDEEP GILL AND DHAVAL PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80285 Primary Status: Cancelled
Address :
241 W. EAST AVE., SUITE 1
CHICO CA 95926
BUTTE 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: MOKBIL AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81690 Primary Status: Current - Active
Address :
21001 SAN RAMON VALLEY BLVD., SUITE C6
SAN RAMON CA 94583
CONTRA COSTA 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: RHO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80994 Primary Status: Current - Active
Address :
4690 NATOMAS BLVD STE 100
SACRAMENTO CA 95835
SACRAMENTO 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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82218 Primary Status: Current - Active
Address :
2712 Homestead Road
SANTA CLARA CA 95051
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: DHAVAL PATEL,DDS
License/Registration Type: Additional Office Permit
License Number: 82444 Primary Status: Current - Active
Address :
4129 S Mooney Blvd, Ste B
VISALIA CA 93277
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82503 Primary Status: Current - Active
Address :
8854 Madison Ave.
FAIR OAKS CA 95628
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: SERGIO VICUNA, D.D.S., INC.
License/Registration Type: Additional Office Permit
License Number: 79179 Primary Status: Current - Active
Address :
1804 19th St
SUITE 100
SACRAMENTO CA 95811-6700
SACRAMENTO 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: MANNEM AND GHAZAL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79978 Primary Status: Current - Active
Address :
10928 TRINITY PKWY
STOCKTON CA 95219
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: DINEA-BERCI DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80357 Primary Status: Current - Active
Address :
2654 MARCONI AVENUE, SUITE 100
SACRAMENTO CA 95821
SACRAMENTO 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: LIN AND JOHAL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81335 Primary Status: Cancelled
Address :
9630 BRUCEVILLE RD SUITE 102
ELK GROVE CA 95757
SACRAMENTO 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: GRACE MIN DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80889 Primary Status: Current - Active
Address :
2660 5TH STREET, SUITE C
ALAMEDA CA 94501
ALAMEDA 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: INAKSH JOHAL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81472 Primary Status: Cancelled
Address :
9640 BRUCEVILLE ROAD., SUITE 101
ELK GROVE CA 95757
SACRAMENTO 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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82448 Primary Status: Current - Active
Address :
150 N. 12th Ave Ste 109
HANFORD CA 93230
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82306 Primary Status: Current - Active
Address :
6766 Bernal Ave., Ste 560
PLEASANTON CA 94566
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82190 Primary Status: Current - Active
Address :
8211 BRUCEVILLE RD. STE. 155
SACRAMENTO CA 95823
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82433 Primary Status: Current - Active
Address :
3521 Arden Way, Ste 101
SACRAMENTO CA 95864
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82405 Primary Status: Current - Active
Address :
2455 Jefferson Blvd Ste 130
WEST SACRAMENTO CA 95691
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82047 Primary Status: Current - Active
Address :
30941 COURTHOUSE DRIVE
UNION CITY CA 94587
ALAMEDA 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: DHAVAL PATEL AND AMARDEEP GILL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81447 Primary Status: Cancelled
Address :
6766 BARNAL AVENUE., SUITE 560
PLEASANTON CA 94566
ALAMEDA 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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82164 Primary Status: Current - Active
Address :
6660 LONE TREE WAY SUITE 7
BRENTWOOD CA 94513
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82176 Primary Status: Current - Active
Address :
1011 HELEN POWER DR.
VACAVILLE CA 95687
SOLANO 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: DHAVAL RAMAN PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82330 Primary Status: Current - Active
Address :
5494 Crossings Drive
Suite 103
ROCKLIN CA 95677
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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82468 Primary Status: Current - Active
Address :
2041 Bronze Star Dr, Ste 100
WOODLAND CA 95776
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: POLUMBO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79690 Primary Status: Cancelled
Address :
3291 STANFORD RANCH ROAD, STE 102
ROCKLIN CA 95765
PLACER 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: GHAZAL, GILL AND NAVARRO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79670 Primary Status: Expired
Address :
1008 W. SHAW AVE, STE 105
FRESNO CA 93711
FRESNO 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: GHAZAL AND LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79475 Primary Status: Cancelled
Address :
10928 TRINITY PKWY
STOCKTON CA 95219
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: PRATIK MAKADIA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80388 Primary Status: Cancelled
Address :
2610 REYNOLDS RANCH PKWY., SUITE 100
LODI CA 95240
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: DHAVAL R. PATEL, D.D.S., INC.
License/Registration Type: Additional Office Permit
License Number: 81203 Primary Status: Current - Active
Address :
995 THARP ROAD, SUITE B
YUBA CITY CA 95993
SUTTER 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: AVALPREET DANG DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81650 Primary Status: Current - Active
Address :
3630 G STREET, SUITE C
MERCED CA 95340
MERCED 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: KHATTAK DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81440 Primary Status: Current - Active
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER 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: DHAVAL PATEL, DDS
License/Registration Type: Additional Office Permit
License Number: 82184 Primary Status: Current - Active
Address :
5925 BIRDCAGE CENTRE LANE SUITE D105
CITRUS HEIGHT CA 95610
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: PACKWOOD CREEK DENTAL GROUP GHAZAL, GILL AND PATEL DENTAL CORPORA
License/Registration Type: Fictitious Name Permit
License Number: 12147 Primary Status: Cancelled
Address :
4129 S. MOONEY BLVD, SUITE B
VISALIA CA 93277
TULARE 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: HIGHLAND DENTAL GROUP, POLUMBO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14250 Primary Status: Cancelled
Address :
3291 STANFORD RANCH RD STE 102
ROCKLIN CA 95765
PLACER 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: PARK WEST DENTAL GROUP, GHAZAL AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13758 Primary Status: Cancelled
Address :
10928 TRINITY PKWY
STOCKTON CA 95219
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: PARK PLACE DENTAL GROUP, RHO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16160 Primary Status: Current - Active
Address :
4690 NATOMAS BLVD., SUITE 100
SACRAMENTO CA 95835
SACRAMENTO 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: SOUTH RIVER DENTAL GROUP, BAUTISTA AND GILL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17059 Primary Status: Current - Active
Address :
2455 JEFFERSON BLVD. SUITE 130
WEST SACRAMENTO CA 95691
YOLO 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: ELK GROVE DENTAL GROUP - MY KIDS DENTIST, INAKSH JOHAL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17659 Primary Status: Current - Active
Address :
9640 BRUCEVILLE ROAD., SUITE 101
ELK GROVE CA 95757
SACRAMENTO 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: DENTISTS OF SAN RAMON DENTAL GROUP, MOKBIL AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18298 Primary Status: Current - Active
Address :
21001 SAN RAMON VALLEY BLVD., SUITE C6
SAN RAMON CA 94583
CONTRA COSTA 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: PLEASANT GROVE DENTAL GROUP, DENTAL CORPORATION OF DHAVAL PATEL
License/Registration Type: Fictitious Name Permit
License Number: 18971 Primary Status: Current - Active
Address :
10357 FAIRWAY DRIVE, SUITE 100
ROSEVILLE CA 95678
PLACER 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: PARKWAY DENTAL GROUP GILL AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15447 Primary Status: Cancelled
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER 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: CLOVIS MODERN DENTISTRY DENTAL GROUP, RIGOR DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15760 Primary Status: Current - Active
Address :
2320 CLOVIS AVENUE, SUITE 102
CLOVIS CA 93612
FRESNO 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: PLEASANTON RIDGE DENTAL GROUP, DHAVAL PATEL AND AMARDEEP GILL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17657 Primary Status: Current - Active
Address :
6766 BARNAL AVENUE., SUITE 560
PLEASANTON CA 94566
ALAMEDA 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: PARK PLACE DENTAL GROUP, HOANG AND RHO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13642 Primary Status: Cancelled
Address :
4690 NATOMAS BLVD STE 100
SACRAMENTO CA 95835
SACRAMENTO 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: WOODLAND SMILES DENTISTRY DENTAL GROUP AMARDEEP GILL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14573 Primary Status: Current - Active
Address :
2041 BRONZE STAR DR STE 100
WOODLAND CA 95776
YOLO 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: ARDEN MODERN DENTISTRY DENTAL GROUP DINEA-BERCI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15451 Primary Status: Current - Active
Address :
2654 MARCONI AVENUE, SUITE 100
SACRAMENTO CA 95821
SACRAMENTO 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: CHICO MODERN DENTISTRY DENTAL GROUP AMARDEEP GILL AND DHAVAL PATEL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15330 Primary Status: Cancelled
Address :
241 W. EAST AVE., SUITE 1
CHICO CA 95926
BUTTE 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: MY KID'S DENTIST DENTAL GROUP, RUCHI ARORA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17445 Primary Status: Current - Active
Address :
2405 IRON POINT ROAD., SUITE 100
FOLSOM CA 95630
SACRAMENTO 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: YUBA CITY MODERN DENTISTRY DENTAL GROUP, DHAVAL R. PATEL, D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 17143 Primary Status: Current - Active
Address :
995 THARP ROAD, SUITE B
YUBA CITY CA 95993
SUTTER 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: PARKWAY DENTAL GROUP, KESHTKAR DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13598 Primary Status: Cancelled
Address :
781 STERLING PKWY
LINCOLN CA 95648
PLACER 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: FIG GARDEN DENTAL GROUP, GHAZAL AND SOOD DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17333 Primary Status: Current - Active
Address :
1008 W SHAW AVE SUITE 105
FRESNO CA 93711
FRESNO 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: PLEASANT HILL SMILES DENTISTRY DENTAL GROUP ALUBAIDI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17552 Primary Status: Current - Active
Address :
2380 Monument Blvd., Suite F
PLEASANT HILL CA 94523
CONTRA COSTA 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: FALLON DENTAL GROUP, PARULEKAR DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17822 Primary Status: Current - Active
Address :
3746 FALLON ROAD
DUBLIN CA 94568
ALAMEDA 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: MY KID'S DENTIST DENTAL GROUP, LIN AND JOHAL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17618 Primary Status: Current - Active
Address :
9630 BRUCEVILLE ROAD., SUITE 102
ELK GROVE CA 95757
SACRAMENTO 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: ROHNERT PARK SMILES DENTISTRY DENTAL GROUP, PATEL AND GILL DENTAL
License/Registration Type: Fictitious Name Permit
License Number: 12017 Primary Status: Current - Active
Address :
6315 COMMERCE BLVD
ROHNERT PARK CA 94928
SONOMA 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: ALAMO SMILES DENTAL GROUP DHAVAL PATEL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13407 Primary Status: Expired
Address :
3000 DANVILLE BLVD STE A
ALAMO CA 94507
CONTRA COSTA 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: WALERGA DENTAL GROUP TIMOTHY BENNETT DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14114 Primary Status: Current - Active
Address :
8008 WALEGRA ROAD, SUITE 100
ANTELOPE CA 95843
SACRAMENTO 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: PACKWOOD CREEK DENTAL GROUP FAREID DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13406 Primary Status: Current - Active
Address :
4129 S MOONEY BLVD STE B
VISALIA CA 93277
TULARE 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: DENTISTS OF LODI DENTAL GROUP GILL AND PATEL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14515 Primary Status: Cancelled
Address :
2610 REYNOLDS RANCH PARKWAY #100
LODI CA 95240
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: DAVIS SMILES DENTISTRY DENTAL GROUP, VICUNA AND MAK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16475 Primary Status: Current - Active
Address :
4515 FERMI PLACE SUITE 106
DAVIS CA 95618
YOLO 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: HIGHLAND DENTAL GROUP, JOESTING DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17631 Primary Status: Current - Active
Address :
3291 STANFORD RANCH ROAD., SUITE 102
ROCKLIN CA 95765
PLACER 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: ALAMO SMILES DENTAL GROUP, SINGH AND PATEL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17058 Primary Status: Current - Active
Address :
3000 DANVILLE BLVD. SUITE A
ALAMO CA 94507
CONTRA COSTA 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: FALLON DENTAL GROUP, KHALED ENTABI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16440 Primary Status: Expired
Address :
3746 FALLON ROAD
DUBLIN CA 94568
ALAMEDA 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: MIDTOWN MODERN DENTAL GROUP SERGIO VICUNA, D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 13205 Primary Status: Current - Active
Address :
1804 19TH STREET, STE. 100
SACRAMENTO CA 95811
SACRAMENTO 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: PARK WEST DENTAL GROUP MANNEM AND GHAZAL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14827 Primary Status: Current - Active
Address :
10928 TRINITY PKWY
STOCKTON CA 95219
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: DENTISTS OF LODI DENTAL GROUP PRATIK MAKADIA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15497 Primary Status: Current - Active
Address :
2610 REYNOLDS RANCH PKWY., SUITE 100
LODI CA 95240
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: FIG GARDEN DENTAL GROUP GHAZAL, GILL AND NAVARRO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14545 Primary Status: Cancelled
Address :
1008 W SHAW AVE STE 105
FRESNO CA 93711
FRESNO 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: DENTISTS OF VISALIA DENTAL GROUP, BEVAN S. FAREID, D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 17115 Primary Status: Current - Active
Address :
827 AKERS STREET., SUITE 104
VISALIA CA 93277
TULARE 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: ALAMEDA LANDING DENTISTRY DENTAL GROUP, GRACE MIN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16479 Primary Status: Current - Active
Address :
2660 5TH ST, STE C
ALAMEDA CA 94501
ALAMEDA 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: DENTISTS OF SANTA ROSA DENTAL GROUP, BAUTISTA AND PATEL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17054 Primary Status: Expired
Address :
370 CODDINGTOWN CENTER
SANTA ROSA CA 95401
SONOMA 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: MERCED MODERN DENTISTRY DENTAL GROUP, AVALPREET DANG DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18164 Primary Status: Current - Active
Address :
3630 G STREET, SUITE C
MERCED CA 95340
MERCED 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: PARKWAY DENTAL GROUP, KHATTAK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17666 Primary Status: Current - Active
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER 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: FREMONT HUB DENTISTRY DENTAL GROUP, DENTAL CORPORATION OF MOKBIL AND GILL
License/Registration Type: Fictitious Name Permit
License Number: 18964 Primary Status: Current - Active
Address :
39025 FREMONT HUB STE 340
FREMONT CA 94538
ALAMEDA 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: BRENTWOOD SMILES DENTISTRY DENTAL GROUP, MOKBIL AND TAHA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 19175 Primary Status: Current - Active
Address :
6660 LONE TREE WAY, SUITE 7
BRENTWOOD CA 94513
CONTRA COSTA COUNTY
Registered Dental Hygienist Alternative Practice to Dentist
License/Registration Role: Dentist
Related Party Role: Registered Dental Hygienist Alternative Practice
Name: PHAM, MYLOAN NGOC
License/Registration Type: Registered Dental Hygienist Alternative Practice
License Number: 653 Primary Status: Current - Active
Address Not Disclosed
