
Dental Board of California
Licensing details for: 79821
Name: ISAAC NAVARRO AND BEVAN FAREID DENTAL CORPORATION
License Type: Additional Office Permit
Primary Status: Expired
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: 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
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: BAUTISTA, REYMOND CARBONELL
License/Registration Type: Dentist License
License Number: 56217 Primary Status: Current - Active
Address :
1221 Albright Walk
SACRAMENTO CA 95818-1682
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: LOPEZ, MICHAEL JAMES
License/Registration Type: Dentist License
License Number: 57591 Primary Status: Current - Active
Address :
1556 Aria Ct
LIVERMORE CA 94550-6077
ALAMEDA 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: FAREID, BEVAN SHOGHI
License/Registration Type: Dentist License
License Number: 64702 Primary Status: Current - Active
Address :
4129 S Mooney Blvd #B
VISALIA CA 93277
TULARE 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: NAVARRO, ISAAC ROBERT
License/Registration Type: Dentist License
License Number: 57304 Primary Status: Current - Active
Address :
4148 S DEMAREE ST
Suite A
VISALIA CA 93277
TULARE COUNTY