Dental Board of California

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: NAGLEE DENTAL GROUP, ENTABI AND FAREID DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 16562 Primary Status: Current - Active

Address :
2682 NAGLEE ROAD. SUITE 110
TRACY CA 95304
SAN JOAQUIN COUNTY

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License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: TRACY SMILES MODERN DENTISTRY DENTAL GROUP ENTABI DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 15167 Primary Status: Current - Active

Address :
2600 S. TRACY BLVD., SUITE 170
TRACY CA 95376
SAN JOAQUIN COUNTY

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License/Registration Role: Owners

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

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License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: TURLOCK SMILES DENTISTRY DENTAL GROUP, TABA DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 17845 Primary Status: Current - Active

Address :
2808 W. Monte Vista Avenue
TURLOCK CA 95380
STANISLAUS COUNTY

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License/Registration Role: Owners

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

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License/Registration Role: Oral Conscious Sedation Certificate

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: ENTABI, KHALED

License/Registration Type: Dentist License

License Number: 56401 Primary Status: Current - Active

Address :
2600 S TRACY BL
STE 170
TRACY CA 95376
SAN JOAQUIN COUNTY

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