Dental Board of California
Licensing details for: 54421
Name: CAYCO-TANGCO, MIRABEL H
License Type: Dentist
Primary Status: Current - Active
Address not disclosed
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: ZEN DENTAL CARE, DENTAL PRACTICE OF MIRABEL CAYCO DDS
License/Registration Type: Fictitious Name Permit
License Number: 15597 Primary Status: Current - Active
Address :
1591 FARMERS LANE
SANTA ROSA CA 95405
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: ZEN DENTAL CARE, DENTAL PRACTICE OF MIRABEL CAYCO DDS
License/Registration Type: Fictitious Name Permit
License Number: 11813 Primary Status: Cancelled
Address :
2448 GUERNEVILLE ROAD #1000
SANTA ROSA CA 95403
SONOMA COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: CAYCO-TANGCO, MIRABEL H
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 4073 Primary Status: Expired
Address :
1591 Farmers Ln
SANTA ROSA CA 95405-7525
SONOMA COUNTY
