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Licensing details for: 11394

Name: JUGAL K. GUPTA, DDS

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Sole Owner

Previous Names: JUGAL KISHORE GUPTA

Address of Record

16049 BASELINE AVE UNIT 3
FONTANA CA 92336
SAN BERNARDINO county
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Practice Location

16049 BASELINE AVE UNIT 3
FONTANA CA 92336
SAN BERNARDINO county
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Issuance Date

April 15, 2014

Expiration Date

October 31, 2026

Current Date / Time

April 5, 2026
11:47:36 AM

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: GUPTA, JUGAL KISHORE

License/Registration Type: Dentist License

License Number: 36370 Primary Status: Current - Active

Address :
11623 CHERRY AVENUE, STE B-2
FONTANA CA 92337
SAN BERNARDINO COUNTY

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