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Licensing details for: 80390

Name: AHMAD MOKBIL DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

6660 LONE TREE WAY, SUITE 7
BRENTWOOD CA 94513
CONTRA COSTA county
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Practice Location

6660 LONE TREE WAY, SUITE 7
BRENTWOOD CA 94513
CONTRA COSTA county
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Issuance Date

November 26, 2019

Expiration Date

March 31, 2026

Current Date / Time

June 6, 2025
10:18:54 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: 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

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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

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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: MOKBIL, AHMAD

License/Registration Type: Dentist License

License Number: 101058 Primary Status: Current - Active

Address :
1016 Riley St
1
1016 Riley St
FOLSOM CA 95630-3265

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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

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