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Licensing details for: 5333

Name: PHILIP KATSUMI NISHINO DDS

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Sole Owner

Address of Record

591 WATT AVENUE
SACRAMENTO CA 95864
SACRAMENTO county
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Issuance Date

April 20, 1994

Expiration Date

June 30, 2007

Current Date / Time

June 6, 2025
8:58:57 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: 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

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