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Licensing details for: 80758

Name: ALTWAL AND SHELAT DDS INC

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

1317 OAKDALE ROAD SUITE 310
MODESTO CA 95355
STANISLAUS county
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Practice Location

1317 OAKDALE ROAD SUITE 310
MODESTO CA 95355
STANISLAUS county
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Issuance Date

January 12, 2021

Expiration Date

June 30, 2025

Current Date / Time

June 6, 2025
11:49:10 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: SHELAT, BHAVINI HARISH

License/Registration Type: Dentist License

License Number: 56738 Primary Status: Current - Active

Address :
4232 ACCLAIM WAY
MODESTO CA 95356
STANISLAUS 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: ALTWAL, IYAD W

License/Registration Type: Dentist License

License Number: 54407 Primary Status: Current - Active

Address :
761 John Kamps Way
RIPON CA 95366-9472
SAN JOAQUIN COUNTY

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