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Licensing details for: 60094

Name: DELGADO, CARLOS MANUEL

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

931 10th St
Suite 346
MODESTO CA 95354-2305
STANISLAUS county
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Practice Location

803 Coffee Rd
Suite 3
MODESTO CA 95355
STANISLAUS county
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Issuance Date

December 29, 2010

Expiration Date

October 31, 2025

Current Date / Time

June 6, 2025
2:59:34 PM

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: DELGADO AND O'DONNELL DENTAL CORPORATION

License/Registration Type: Additional Office Permit

License Number: 79984 Primary Status: Cancelled

Address :
8908 MADISON AVENUE
FAIR OAKS CA 95628
SACRAMENTO COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: RIVER CITY DENTAL GROUP DELGADO AND O'DONNELL DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 14857 Primary Status: Expired

Address :
8908 MADISON AVE
FAIR OAKS CA 95628
SACRAMENTO COUNTY

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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: RIVER CITY DENTAL GROUP DELGADO AND O'DONNELL DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 14857 Primary Status: Expired

Address :
8908 MADISON AVE
FAIR OAKS CA 95628
SACRAMENTO COUNTY

Map

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