Dental Board of California
Licensing details for: 947
Name: Borrero Fonseca, Maria Camila
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Minor
Previous Names: BORRERO, MARIA CAMILA ❖ BORRERO, CAMILA
Address of Record
569 W LOWELL AVE
STE 200
TRACY CA 95376
SAN JOAQUIN county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL FUN ZONE - BORRERO DENTAL OFFICE #2
License/Registration Type: Fictitious Name Permit
License Number: 12452 Primary Status: Cancelled
Address :
675 CONTRA COSTA BLVD
PLEASANT HILL CA 94523
CONTRA COSTA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL FUN ZONE, DENTAL GROUP OF CAMILA BORRERO, DDS,
License/Registration Type: Fictitious Name Permit
License Number: 7659 Primary Status: Cancelled
Address :
569 W LOWELL BOULEVARD
TRACY CA 95376
SAN JOAQUIN COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL FUNZONE, DENTAL GROUP OF MARIA CAMILA BORRERO FONSECA, DDS
License/Registration Type: Fictitious Name Permit
License Number: 13920 Primary Status: Current - Active
Address :
569 W LOWELL BLVD STE 200
TRACY CA 95376
SAN JOAQUIN COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SURFSIDE KIDS DENTAL GROUP, RAWLINS & LYONS
License/Registration Type: Fictitious Name Permit
License Number: 13088 Primary Status: Expired
Address :
675 CONTRA COSTA BLVD
PLEASANT HILL CA 94523
CONTRA COSTA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SPLASH KIDS DENTAL CARE DENTAL OFFICE OF KAUR & BORRERO DDS DENTAL CORP.
License/Registration Type: Fictitious Name Permit
License Number: 15378 Primary Status: Expired
Address :
1801 TULLY RD STE A1
MODESTO CA 95350
STANISLAUS COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SPARKLE KIDS DENTAL CARE, DENTAL OFFICE OF KAUR & BORRERO DDS DENTAL CORP.
License/Registration Type: Fictitious Name Permit
License Number: 16288 Primary Status: Current - Active
Address :
1801 TULLY RD., STE A.1
MODESTO CA 95350
STANISLAUS 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: Borrero Fonseca, Maria Camila
License/Registration Type: Dentist License
License Number: 51046 Primary Status: Current - Active
Address :
569 W LOWELL AVE
STE 200
TRACY CA 95376
SAN JOAQUIN COUNTY
