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Licensing details for: 81203

Name: DHAVAL R. PATEL, D.D.S., INC.

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

995 THARP ROAD, SUITE B
YUBA CITY CA 95993
SUTTER county
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Practice Location

995 THARP ROAD, SUITE B
YUBA CITY CA 95993
SUTTER county
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Issuance Date

May 11, 2022

Expiration Date

January 31, 2026

Current Date / Time

June 6, 2025
7:28:49 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: 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

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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: 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: 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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