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Licensing details for: 3815

Name: LAMANTIA, NICOLE RENEE

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

4347 Nobel Dr
Unit 133
SAN DIEGO CA 92122
SAN DIEGO county
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Issuance Date

October 30, 2018

Expiration Date

November 30, 2024

Current Date / Time

June 6, 2025
9:46:54 PM

License Relationships

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: LAMANTIA, NICOLE RENEE

License/Registration Type: Dentist License

License Number: 103277 Primary Status: Current - Active

Address :
4347 NOBEL DRIVE
Unit 133
SAN DIEGO CA 92122
SAN DIEGO COUNTY

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