Dental Board of California
Licensing details for: 79212
Name: TIMOTHY BENNETT DENTAL CORPORATION
License Type: Additional Office Permit
Primary Status: Current - Active
Organization Classification: Corporation
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: BENNETT, TIMOTHY PAUL
License/Registration Type: Dentist License
License Number: 28517 Primary Status: Current - Active
Address :
P.O. Box 593
ROSEVILLE CA 95661-9998
PLACER COUNTY
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: PATEL, DHAVAL RAMAN
License/Registration Type: Dentist License
License Number: 54297 Primary Status: Current - Active
Address :
10357 Fairway Dr
Ste 100
ROSEVILLE CA 95678-3544
PLACER COUNTY
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: VICUNA, SERGIO
License/Registration Type: Dentist License
License Number: 53129 Primary Status: Current - Active
Address :
5004 S Land Park Dr
SACRAMENTO CA 95822-2504
SACRAMENTO COUNTY
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: GILL, AMARDEEP KAUR
License/Registration Type: Dentist License
License Number: 50464 Primary Status: Current - Active
Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO COUNTY
