Dental Board of California
Licensing details for: 3566
Name: GOLLA, KEERTHI
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Minor
Address of Record
160 Birch St Ste A
REDWOOD CITY CA 94062-1307
SAN MATEO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: REDWOOD SMILES, DENTAL PRACTICE OF KEERTHI GOLLA, DMD, INCORPORATED
License/Registration Type: Fictitious Name Permit
License Number: 14192 Primary Status: Expired
Address :
160 BIRCH ST STE A
REDWOOD CITY CA 94062
SAN MATEO COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Oral Conscious Sedation Certificate
Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Name: GOLLA, KEERTHI
License/Registration Type: Dentist License
License Number: 100398 Primary Status: Current - Active
Address :
52 Verde Way
FREMONT CA 94539-2206
ALAMEDA COUNTY
