Dental Board of California
Licensing details for: 4515
Name: MYLAD, BOTAMENA M
License Type: Oral Conscious Sedation
Primary Status: Current - Active
Specialty: Adult
Address of Record
24119 Hemlock Ave
Ste 108
MORENO VALLEY CA 92557-7220
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: MORENO VALLEY MODERN DENTISTRY DENTAL GROUP, MYLAD DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18279 Primary Status: Current - Active
Address :
24119 HEMLOCK AVENUE, SUITE 108
MORENO VALLEY CA 92557
RIVERSIDE 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: MYLAD, BOTAMENA M
License/Registration Type: Dentist License
License Number: 103690 Primary Status: Current - Active
Address :
24119 Hemlock Ave
STE 108
MORENO VALLEY CA 92557-7220
RIVERSIDE COUNTY
