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Licensing details for: 81521

Name: TABA DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

2808 W. Monte Vista Avenue
TURLOCK CA 95380
STANISLAUS county
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Practice Location

2808 W. Monte Vista Avenue
TURLOCK CA 95380
STANISLAUS county
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Issuance Date

May 17, 2023

Expiration Date

October 31, 2026

Current Date / Time

June 6, 2025
10:32:52 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: 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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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: ENTABI, KHALED

License/Registration Type: Dentist License

License Number: 56401 Primary Status: Current - Active

Address :
2600 S TRACY BL
STE 170
TRACY CA 95376
SAN JOAQUIN 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: TABA, ARFAN

License/Registration Type: Dentist License

License Number: 41579 Primary Status: Current - Active

Address :
3221 Amethyst Way

TURLOCK CA 95382-9217
STANISLAUS COUNTY

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