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Licensing details for: 10179

Name: PATEL AND GHAZAL DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Secondary Status: Cancelled at the Request of the LicenseePrimary Status Definition

Address of Record

3290 ARENA BLVD.
STE. 610
SACRAMENTO CA 95834
SACRAMENTO county
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Issuance Date

April 14, 2010

Expiration Date

June 30, 2018

Current Date / Time

June 6, 2025
8:48:58 PM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: GHAZAL, CAROLYN G

License/Registration Type: Dentist License

License Number: 38682 Primary Status: Current - Active

Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY

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