Dental Board of California
Licensing details for: 63917
Name: KESHTKAR, ARDALAN
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
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: KESHTKAR DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79367 Primary Status: Expired
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER COUNTY
FNP Owners
License/Registration Role: Owners
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: 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
Registered Dental Hygienist Alternative Practice to Dentist
License/Registration Role: Dentist
Related Party Role: Registered Dental Hygienist Alternative Practice
Name: CARIAS, ERICK FABRICIO
License/Registration Type: Registered Dental Hygienist Alternative Practice
License Number: 378 Primary Status: Current - Active
Address Not Disclosed
