Dental Board of California
Licensing details for: 4604
Name: PHILIP KATSUMI NISHINO DDS
License Type: Additional Office Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: PHILIP KATSUMI NISHINO
Address of Record
1511 SYCAMORE AVENUE
SUITE A
HERCULES CA 94547
CONTRA COSTA county
Map
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: NISHINO, PHILIP KATSUMI
License/Registration Type: Dentist License
License Number: 23941 Primary Status: Current - Active
Address :
104 Sunhaven Rd
DANVILLE CA 94506-1901
CONTRA COSTA COUNTY
